MOHAVE MEDICAL ONCOLOGY CENTER (NPI# 1386834844) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386834844 |
| Entity Type | Organization |
| Organization Name | MOHAVE MEDICAL ONCOLOGY CENTER |
| Practice Address |
3801 Santa Rosa Suite 200 Kingman AZ 86401-2311 |
| Mailing Address |
Po Box 777550 Henderson NV 89077-7550 |
| Practice Telephone | 7024717779 |
| Practice Fax Number | 7024710484 |
| Mailing Telephone | 7024717779 |
| Mailing Fax Number | 7024710484 |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2012-01-31 |
| Authorized Official Name | JULIE LINN KONIE (PRACTICE MANAGER) |
| Authorized Official Telephone | 7024717779 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
MD18958 | AZ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 056037 | 05 |
| Street Address |
3801 SANTA ROSA SUITE 200 |
| City | KINGMAN |
| State | AZ |
| Zip Code | 86401-2311 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194018382 | Debra D Fuller | Physical Therapy Assistant | 3801 Santa Rosa, Kingman, AZ 86401-2311 | 2011-05-19 |
| 1417289810 | Hualapai Mountain Medical Profees, LLC | Specialist | 3801 Santa Rosa, Kingman, AZ 86401-2311 | 2010-02-10 |
| 1881827806 | Hualapai Emergency Physician Partners Pllc | Emergency Medicine | 3801 Santa Rosa, Kingman, AZ 86401-2311 | 2009-08-25 |
| 1962637710 | Hualapai Mountain Medical Center, LLC | General Acute Care Hospital | 3801 Santa Rosa, Kingman, AZ 86401-2311 | 2009-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053858704 | Robert Cole | Nurse Practitioner | 3545 Cheyenne Ave, King,an, AZ 86401 | 2017-01-19 |
| 1710420286 | Acadia Healthcare Inc | Nurse Practitioner | 2699 E Andy Devine, Suite B, Kingman, AZ 86401 | 2016-11-30 |
| 1174079800 | Kenneth Mcadow | Physical Therapist | 2404 Stockton Hill Road, Suite K, Kingman, AZ 86401 | 2016-09-01 |
| 1649659483 | Tracie Hirz | Case Manager/Care Coordinator | 3656 Packsaddle Road, Kingman, AZ 86401 | 2015-05-27 |
| 1548657695 | Chelsea Presbrey | Family Medicine | 2202 N Stockton Hill Rd Ste 100, Kingman, AZ 86401 | 2015-04-15 |
| 1649617226 | Abubakr Abdelmunim Tagelsir Abdelaziz | Internal Medicine | 2501 N Stockton Hill Rd Ste 102, Kingman, AZ 86401 | 2013-05-23 |
| 1205173325 | Patricia Jean Marko | Social Worker | 2002 Stockton Hill Road, Mohave Mental Health Clinic, Inc., Kingman, AZ 86401 | 2013-01-09 |
| 1770835316 | Hae Young Lee | Dentist | 2058 Maya Dr., Kingman, AZ 86401 | 2012-10-05 |
| 1255681623 | Hilary Radler | Specialist/Technologist | 3033 Macdonald, Kingman, AZ 86401 | 2012-09-13 |
| 1477836880 | Goodwill of Northern Arizona | Exclusive Provider Organization | 2369 Airway Avenue, Kingman, AZ 86401 | 2011-09-21 |
| Find all providers in zip 86401 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912158221 | Cancer Center of Kansas, P.a. | Internal Medicine | 750 Avenue D, Kingman, KS 67068-0376 | 2008-10-06 |
| 1164423257 | Hamdy A Mohtaseb | Internal Medicine | 1755 Airway Avenue, Kingman, AZ 86409 | 2005-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740700798 | Iloabueke Gabriel Chineke | Internal Medicine | 3838 N. Campbell Ave, Tucson, AZ 85719-1454 | 2017-06-21 |
| 1699035717 | Robert Dukjun Yoo | Internal Medicine | 1432 S Dobson Rd Ste 106, Mesa, AZ 85202 | 2012-05-22 |
| 1548538499 | Robert David Ligorsky | Internal Medicine | 11035 E Acoma Dr, Scottsdale, AZ 85255-1865 | 2011-12-07 |
| 1972895340 | Abhishek Harshad Patel | Internal Medicine | 5750 W Thunderbird Rd Ste C300, Glendale, AZ 85306-4666 | 2011-05-04 |
| 1487989927 | Clevius Arnold Curry | Internal Medicine | 10500 E Lost Canyon Dr Lot 8, Scottsdale, AZ 85255-4454 | 2009-10-15 |
| 1972746287 | Keerti Khandelwal | Internal Medicine | 1951 W 25th St Ste F, Yuma, AZ 85364-6924 | 2009-04-16 |
| 1336384809 | Irwin W Tischler | Internal Medicine | 4638 E Berneil Dr, Phoenix, AZ 85028-5500 | 2008-12-11 |
| 1205086378 | Desert Springs Cancer Care, P.l.c. | Internal Medicine | 8950 S 52nd St, Suite 101, Tempe, AZ 85284-1046 | 2008-09-25 |
| 1114182185 | Maria Mercedes Brenneisen | Internal Medicine | 21600 W El Grande Trl, Wickenburg, AZ 85390-3476 | 2008-07-18 |
| 1568625077 | Lida A Mina | Internal Medicine | 2940 E. Banner Gateway Dr., Gilbert, AZ 85234 | 2008-07-03 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.