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General NPI Number Information
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NPI Number | 1689719817
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Entity Type | Organization
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Legal Business Name | HAVASU WOMEN'S HEALTH CENTER PC
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 03/21/2012
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Provider Practice Location Address
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Address Line | 1840 MESQUITE AVE STE H
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86403-5771
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Country | US
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Telephone | 928-855-8176
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Fax | 928-855-1995
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Provider Business Mailing Address
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Address Line | 1840 MESQUITE AVE STE H
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86403-5771
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Country | US
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Telephone | 928-855-8176
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Fax | 928-855-1995
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NICK RIZOS
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Credential | MD
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Telephone | 928-855-8176
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 14298
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License Number State | AZ
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