Thomas G Dallman MD PC

Primary specialty

Hepatology PhysicianTaxonomy code 207RI0008X

License

16390 Issued in AZ

Legal business name

THOMAS G DALLMAN MD PC

Practice address

1355 Ramar Rd
Suite 12
Bullhead City, AZ 86442-7100

Phone

(928) 763-9505

Fax

(928) 763-7370

NPI assigned

Nov 23, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Thomas Gary Dallman, MDNPI 1568643757

Title

President

Phone

(928) 763-9505

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Thomas Gary Dallman, M.D.

  • Internal Medicine Physician
  • Bullhead City, AZ
  • NPI 1568643757
  NPD (past) Authorized official

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

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669455515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 RAMAR RD",
            "address_2": "SUITE 12",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864427100",
            "telephone_number": "928-763-9505",
            "fax_number": "928-763-7370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 RAMAR RD",
            "address_2": "SUITE 12",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864427100",
            "telephone_number": "928-763-9505",
            "fax_number": "928-763-7370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS G DALLMAN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DALLMAN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "GARY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "928-763-9505",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0008X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hepatology",
            "state": "AZ",
            "license": "16390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "AZ0189940",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Hepatology Physician in Bullhead City, AZ
• Providers in Bullhead City, AZ by specialty
• Hepatology Physician 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.