Individual provider · NPI-1

Elliot Charles Maness, DO

Surgery · Bullhead City, AZ

NPI number1861476145
StatusActive
Last updated in NPPESAug 31, 2020

Details

NPI
1861476145
Entity type
Individual (NPI-1)
Name
Mr. Elliot Charles Maness
Credential
DO
Sex
Male
Sole proprietor
No
Enumeration date
Dec 1, 2005
Certification date
Aug 31, 2020
Last updated
Aug 31, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208600000X Surgery3609AZYes

Practice location

2755 Silver Creek Rd Ste 111
Bullhead City, AZ 86442-8343

Phone 928-704-7163 · Fax 928-444-1326

Mailing address

2755 Silver Creek Rd Ste 111
Bullhead City, AZ 86442-8343

Phone 928-704-7163 · Fax 928-444-1326

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