DOCTORS SURGERY CENTER OF KINGMAN, LLC
Ambulatory Health at Sycamore Ave, Kingman, AZ

License number
Arizona OSC 2913
Category
Ambulatory Health
Type
Ambulatory Surgical
Owner
Name: MR. MYRON E MACHULA
Title: EXECUTIVE ADMINISTRATOR
Phone: (928) 681-4214
Address
Address
1740 Sycamore Ave, Kingman, AZ 86409
National Provider ID: 1407819857
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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DOCTOR'S SURGERY CENTER OF KINGMAN, LLC

Kingman, AZ

Status:
Inactive
Industry:
Medical Doctor's Office
Registration:
Jan 7, 2000
Phone:
(928) 681-4214 (Phone)
Addresses:
1700 Sycamore, Kingman, AZ 86401 (Physical)
1740 Sycamore Ave, Kingman, AZ 86409
State ID:
L-0935439-6
Expiration:
PERPETUAL
Owner, Surgeons:
Surgery Centers Of America Ii (Manager), 1601 S State St, Edmond, OK 73013 (Physical),Ron Olsen Chairman, Chairman of the Board, inactive,Jay Govan Manager, inactive,...
Agent:
National Registered Agents Inc,2390 E Camelback Rd, Phoenix, AZ 85016 (Physical)

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