Doctors Surgery Center of Kingman, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

OSC 2913 Issued in AZ

Legal business name

DOCTORS SURGERY CENTER OF KINGMAN, LLC

Practice address

1740 Sycamore Ave
Kingman, AZ 86409-0927

Phone

(928) 681-4214

Fax

(928) 681-4226

NPI assigned

Apr 7, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Myron E Machula

Title

Executive Administrator

Phone

(928) 681-4214

Specialties & licenses 1

Addresses

Other identifiers 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407819857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 SYCAMORE AVENUE",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "86409",
            "telephone_number": "928-681-4214",
            "fax_number": "928-681-4226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 SYCAMORE AVE",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864090927",
            "telephone_number": "928-681-4214",
            "fax_number": "928-681-4226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTORS SURGERY CENTER OF KINGMAN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MACHULA",
        "authorized_official_first_name": "MYRON",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "EXECUTIVE ADMINISTRATOR",
        "authorized_official_telephone_number": "928-681-4214",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "AZ",
            "license": "OSC 2913",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSAZ",
            "identifier": "AZ0207340",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "629420",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diagnostic Ultrasound Solutions, LLC
• Ronald Anthony Dicarlo II, DMD
• Kerry Lyn Dinnella, RN
• DMV Shuttle Service
• Anh Doan
• Alexander Dolan, DO
• Rosemarie Jane Dolman
• Jennifer Donahue
• Aaron King Donnell, PTA
• Barbara E Dorf, D.C.

• Ambulatory Surgical Clinic/Center in Kingman, AZ
• Providers in Kingman, AZ by specialty
• Ambulatory Surgical Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.