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BENEZE MEDICAL GROUP NPI 1083659361


NPI Information

NPI: 1083659361
Provider Name: BENEZE MEDICAL GROUP
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 03D0976860

Address:
3003 HIGHWAY 95
SUITE G73
BULLHEAD CITY, AZ
ZIP 86442
Phone: (928) 758-7700
Get Directions

BENEZE MEDICAL GROUP is a family medicine in Bullhead City, AZ. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. BENEZE MEDICAL GROUP NPI is 1083659361. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3003 HIGHWAY 95
SUITE G73
BULLHEAD CITY, AZ
ZIP 86442-860
Phone: (928) 758-7700
Fax: (928) 758-5700

The provider's authorized official is Larry Joseph Keating .
The authorized official title is Vice President and has the following contact phone number (928) 758-7700.

The CLIA number assigned to this NPI record is 03D0976860 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/19/2006 and was last updated on 11/17/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine14102ARIZONAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1E80456MEDICARE UPINARIZONA
262740MEDICARE ID-TYPE UNSPECIFIEDARIZONAMEDICARE GROUP BILLING
3R09321MEDICARE UPINARIZONA
4R15868MEDICARE UPINARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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