Arizona Institure of Medicine & Surgery

Key facts

NPI: 1962657783
Entity type: Organization (NPI type 2)
Primary specialty: Clinical Medical Laboratory 291U00000X
License: 03D0534286 (AZ)
Legal business name: ARIZONA INSTITURE OF MEDICINE & SURGERY
Practice address: 3636 Stockton Hill Rd
Kingman, AZ 86409
Phone: (928) 757-3680
Fax: (928) 757-3614
NPI assigned: Nov 20, 2008
Organization subpart: No

Authorized official

Name: Azam S Khan
Title: Chief Administrative Officer
Phone: (928) 757-3636

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Arizona Institute of Medicine & Surgery Urgent Care Clinic/Center · Kingman, AZ · NPI 1396990800

NPD tax ID

Practitioners 1

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

Muhammad Azam Khan, MD Surgery Physician · Kingman, AZ · NPI 1508850116

NPD (past)

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
03D1022941	Arizona Institute of Medicine and Surgery 3636 Stockton Hill Rd, Kingman, AZ 86409	Certificate of waiver	Mar 3, 2028
03D2091455	Weidner Family Medicine 3636 Stockton Hill Rd, Ste 2, Kingman, AZ 86409	Certificate of waiver	Feb 11, 2027

National Provider Directory

Tax ID family: Aims Outpatient Treatment Center (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Urgent Care Clinic/Center	261QU0200X	OTC-0660	AZ
Clinical Medical Laboratory	291U00000X	03D0534286	AZ	Yes
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier	335V00000X	OTC-0660	AZ

Addresses

Primary practice location

3636 Stockton Hill Rd
Kingman, AZ 86409

Mailing address

3636 Stockton Hill Rd
Kingman, AZ 86409-0514
Phone (928) 757-3680

Other identifiers

Identifier	Type	State	Issuer
167933	Medicaid	AZ
OTC-0660	Other	AZ	MEDICAL FACILITY LICENSING

Other names

Outpatien Treatment Ctr Other name

Other providers in Kingman, AZ

All providers in Kingman, AZ · Clinical Medical Laboratory in Arizona

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 4, 2018. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.