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General NPI Number Information
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NPI Number | 1043081664
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Entity Type | Organization
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Legal Business Name | YUMA SOUTHWEST MEDICINE
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Dates
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Enumeration Date | 01/11/2024
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Last Update Date | 02/28/2024
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Provider Practice Location Address
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Address Line | 4792 E COUNTY 15 1/2 ST
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City | YUMA
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State | AZ
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Zip | 85365-9382
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Country | US
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Telephone | 623-632-7210
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Fax |
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Provider Business Mailing Address
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Address Line | 4792 E COUNTY 15 1/2 ST
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City | YUMA
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State | AZ
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Zip | 85365-9382
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Country | US
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Telephone | 623-632-7210
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN/FOUNDER
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Name | DR. TREVOR SAXMAN
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Credential | DO
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Telephone | 623-632-7210
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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