Organization · NPI-2

Bullhead City Clinic Corp

Surgery · Bullhead City, AZ

NPI number1962429878

StatusActive

Last updated in NPPESJun 25, 2025

Details

NPI: 1962429878
Entity type: Organization (NPI-2)
Legal business name: Bullhead City Clinic Corp
Organization subpart: Yes
Enumeration date: Jul 16, 2006
Certification date: Jun 25, 2025
Last updated: Jun 25, 2025

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
208600000X	Surgery	4270	AZ	Yes
207Q00000X	Family Medicine	–	–
207RG0100X	Internal Medicine, Gastroenterology	–	–
207V00000X	Obstetrics & Gynecology	–	–
207Y00000X	Otolaryngology	–	–
208800000X	Urology	–	–

Practice location

2500 Canyon Rd Bldg B
Bullhead City, AZ 86442-8624

Phone 928-763-9290

Mailing address

Po Box 689022
Franklin, TN 37068-9022

Phone 615-465-3371

Authorized official

Kristina Music
Director Of Provider Enrollment
8778929815

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