Active NPI
Southwest Neurology P C
- Neurology Physician
- Fort Mohave, AZ
National Provider Identifier
1467637280
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 22788
- Legal business name
- SOUTHWEST NEUROLOGY P C
- Practice address
- 5300 S Highway 95
Suite L
Fort Mohave, AZ 86426-9251 - Phone
- (928) 788-4260
- Fax
- (928) 788-4262
- NPI assigned
- Dec 31, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Ronald S. Bennett, M.D.
- Title
- President
- Phone
- (928) 788-4260
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 22788 | AZ | Primary |
Addresses
Primary practice location
5300 S Highway 95
Suite L
Fort Mohave, AZ 86426-9251
Mailing address
PO Box 10499
Fort Mohave, AZ 86427-0499
Phone (928) 788-4260
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 215691002 | Medicaid | AZ | |
| 1415509-3 | Other | AZ | CORPORATION REGISTRATION |
National Provider Directory
National Provider DirectoryLocations
1510 Turquoise Rd
Bullhead City, AZ 86442
Phone (928) 763-8515
5300 S Highway 95
Ste L
Fort Mohave, AZ 86426
Phone (920) 788-4260
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1199059200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1209513600000",
"number": "1467637280",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10499",
"city": "FORT MOHAVE",
"state": "AZ",
"postal_code": "864270499",
"telephone_number": "928-788-4260",
"fax_number": "928-788-4262"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5300 S HIGHWAY 95",
"address_2": "SUITE L",
"city": "FORT MOHAVE",
"state": "AZ",
"postal_code": "864269251",
"telephone_number": "928-788-4260",
"fax_number": "928-788-4262"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOUTHWEST NEUROLOGY P C",
"organizational_subpart": "NO",
"enumeration_date": "2007-12-31",
"last_updated": "2008-04-30",
"status": "A",
"authorized_official_last_name": "BENNETT",
"authorized_official_first_name": "RONALD",
"authorized_official_middle_name": "S.",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "928-788-4260",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Neurology",
"state": "AZ",
"license": "22788",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "215691002",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CORPORATION REGISTRATION",
"identifier": "1415509-3",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Mohave, AZ
- Serenity Home Health LLC
- Valerie A Silvas, PHARM D
- Smiths Food & Drug Centers Inc (Smiths Pharmacy #473)
- Emanuel H Solomon, PHARMACIST
- Elizabeth Sosa, COTA
- Macy Joy Stevens
- Allen E Stout, DC, FNP
- Sunrise Wellness Solution PLLC
- Surgery Specialists at the River, PLLC
- Sandra Kay Alojado Tabangcora, DDS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.