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General NPI Number Information
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NPI Number | 1235385923
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Entity Type | Organization
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Legal Business Name | SILVER RIDGE PERINATAL CENTER, INC.
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Dates
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Enumeration Date | 08/13/2008
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Last Update Date | 08/13/2008
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Provider Practice Location Address
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Address Line | 3931 STOCKTON HILL RD SUITE A
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City | KINGMAN
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State | AZ
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Zip | 86409-2426
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Country | US
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Telephone | 928-681-4273
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6011
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City | KINGMAN
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State | AZ
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Zip | 86402-6011
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Country | US
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Telephone | 928-607-2802
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES ROBERT THOMAS
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Credential | PHD., M.D.
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Telephone | 928-607-2802
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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