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General NPI Number Information
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NPI Number | 1063408649
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Entity Type | Organization
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Legal Business Name | AIMS OUTPATIENT SURGERY
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Dates
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Enumeration Date | 09/20/2005
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Last Update Date | 06/04/2018
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Provider Practice Location Address
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Address Line | 3636 N STOCKTON HILL RD
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City | KINGMAN
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State | AZ
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Zip | 86409
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Country | US
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Telephone | 928-757-3690
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Fax | 928-757-3635
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Provider Business Mailing Address
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Address Line | 3636 N STOCKTON HILL RD
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City | KINGMAN
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State | AZ
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Zip | 86409-0514
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Country | US
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Telephone | 928-757-3690
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Fax | 928-757-3635
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Authorized Official
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Title or Position | CHIEF ADMINISTRATIVE OFFICER
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Name | MR. AZAM S. KHAN
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Credential |
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Telephone | 928-757-3636
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | OSC0074
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License Number State | AZ
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