MEDICARE: BULLHEAD CITY CLINIC CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician
2	207RG0100X	Gastroenterology Physician
3	207V00000X	Obstetrics & Gynecology Physician
4	207Y00000X	Otolaryngology Physician
5	208800000X	Urology Physician
6	208600000X	Surgery Physician	4270	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962429878
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BULLHEAD CITY CLINIC CORP

Provider Business Mailing Address
First Line	:	PO BOX 689022
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37068-9022
Country	:	US
Telephone Number	:	615-465-3371
Fax Number	:

Provider Business Practice Location Address
First Line	:	2500 CANYON RD BLDG B
Second Line	:
City	:	BULLHEAD CITY
State	:	AZ
Zip	:	86442-8624
Country	:	US
Telephone Number	:	928-763-9290
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF PROVIDER ENROLLMENT
Name	:	KRISTINA MUSIC
Credential	:
Telephone Number	:	877-892-9815

Provider Enumeration Date	:	07/16/2006
Last Update Date	:	06/25/2025

Similar Medicare Providers

1336128958 — DR. JUANITO Y LIM MD
Practice Location Address:

2500 CANYON RD BLDG D , SUITE 1
BULLHEAD CITY, AZ
86442-8624

Practice Phone: 928-763-8600
Practice Fax: 928-704-2201

1295838605 — RANDY CHADWELL PA
Practice Location Address:

2500 CANYON RD BLDG B
BULLHEAD CITY, AZ
86442-8624

Practice Phone: 928-444-1491
Practice Fax: 435-787-1913

1114367364 — LUDANE TONIE SIMMONS M.D.
Practice Location Address:

2500 CANYON RD BLDG B
BULLHEAD CITY, AZ
86442-8624

Practice Phone: 928-763-9290
Practice Fax: 928-763-7628

1386064863 — NATHAN CHAD WEAVER D.O.
Practice Location Address:

2500 CANYON RD STE 1
BULLHEAD CITY, AZ
86442-8624

Practice Phone: 928-444-1491
Practice Fax:

1164881405 — ALL WOMEN'S REGIONAL MEDICAL CENTER, PC
Practice Location Address:

2500 CANYON RD , STE A1
BULLHEAD CITY, AZ
86442-8624

Practice Phone: 928-704-4499
Practice Fax: 928-704-4949

1154784023 — THOMAS GENE HOOKE DPM
Practice Location Address:

2500 CANYON RD STE 2
BULLHEAD CITY, AZ
86442-8624

Practice Phone: 928-444-1491
Practice Fax: 928-444-1330

Directions to “BULLHEAD CITY CLINIC CORP ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.