CHARLES H. TADLOCK, M.D. LTD. (NPI# 1548422876) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548422876 |
| Entity Type | Organization |
| Organization Name | CHARLES H. TADLOCK, M.D. LTD. |
| Other Organization Name | CENTER FOR PAIN MANAGEMENT |
| Practice Address |
1912 Miami Ave Kingman AZ 86401-4127 |
| Mailing Address |
6725 S Eastern Ave Suite 6 Las Vegas NV 89119-3916 |
| Practice Telephone | 7024740200 |
| Practice Fax Number | 7029465328 |
| Mailing Telephone | 7024740200 |
| Mailing Fax Number | 7029465328 |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2014-02-18 |
| Authorized Official Name | MRS. TAMMY R SHAFFER (ADMINISTRATOR) |
| Authorized Official Telephone | 7024740200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
4873 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP4247 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
26067 | AZ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | MEDICARE INDIVIDUAL PIN (TADLOCK) | 35714 | 01 |
| AZ | MEDICARE PIN GERALD JONES, PA-C | Z146133 | 01 |
| AZ | MEDICARE PIN JULIE BROWN, FNP | Z149395 | 01 |
| AZ | 069618 | 05 | |
| AZ | RR MEDICARE | 720000127 | 01 |
| Other Name | Type Code |
|---|---|
| CENTER FOR PAIN MANAGEMENT | Doing Business As Name - Organization |
| Street Address |
1912 MIAMI AVE |
| City | KINGMAN |
| State | AZ |
| Zip Code | 86401-4127 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053858704 | Robert Cole | Nurse Practitioner | 3545 Cheyenne Ave, King,an, AZ 86401 | 2017-01-19 |
| 1710420286 | Acadia Healthcare Inc | Nurse Practitioner | 2699 E Andy Devine, Suite B, Kingman, AZ 86401 | 2016-11-30 |
| 1174079800 | Kenneth Mcadow | Physical Therapist | 2404 Stockton Hill Road, Suite K, Kingman, AZ 86401 | 2016-09-01 |
| 1649659483 | Tracie Hirz | Case Manager/Care Coordinator | 3656 Packsaddle Road, Kingman, AZ 86401 | 2015-05-27 |
| 1548657695 | Chelsea Presbrey | Family Medicine | 2202 N Stockton Hill Rd Ste 100, Kingman, AZ 86401 | 2015-04-15 |
| 1649617226 | Abubakr Abdelmunim Tagelsir Abdelaziz | Internal Medicine | 2501 N Stockton Hill Rd Ste 102, Kingman, AZ 86401 | 2013-05-23 |
| 1205173325 | Patricia Jean Marko | Social Worker | 2002 Stockton Hill Road, Mohave Mental Health Clinic, Inc., Kingman, AZ 86401 | 2013-01-09 |
| 1770835316 | Hae Young Lee | Dentist | 2058 Maya Dr., Kingman, AZ 86401 | 2012-10-05 |
| 1255681623 | Hilary Radler | Specialist/Technologist | 3033 Macdonald, Kingman, AZ 86401 | 2012-09-13 |
| 1477836880 | Goodwill of Northern Arizona | Exclusive Provider Organization | 2369 Airway Avenue, Kingman, AZ 86401 | 2011-09-21 |
| Find all providers in zip 86401 | ||||
| Taxonomy Code | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073510673 | Attiya Salim | Anesthesiology | 3269 N Stockton Hill Rd, Kingman, AZ 86401-3619 | 2005-06-28 |
| 1073699112 | Aims Physicians and Surgeons | Anesthesiology | 3636 Stockton Hill Road, Kingman, AZ 86409 | 2006-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629679923 | Advanced Spine and Pain LLC | Anesthesiology | 4566 E Inverness Ave Ste 205, Mesa, AZ 85206-4634 | 2020-11-03 |
| 1104449628 | The Pain Institute of Southern Arizona PC | Anesthesiology | 2241 W 16th Street, Safford, AZ 85546 | 2020-05-19 |
| 1043832223 | Desert Anesthesia Specialists LLC | Anesthesiology | 8865 E Bell Rd Ste 101, Scottsdale, AZ 85260-1594 | 2020-05-11 |
| 1841811106 | Bcg Anesthesia Pllc | Anesthesiology | 12955 N 145th Ave, Surprise, AZ 85379-4487 | 2020-04-28 |
| 1891344958 | Orion Pain Corp | Anesthesiology | 16700 N Thompson Peak Pkwy Ste 170, Scottsdale, AZ 85260-2386 | 2019-09-10 |
| 1558826438 | Agave Anesthesia LLC | Anesthesiology | 5533 E Bell Rd Ste 111, Scottsdale, AZ 85254-1256 | 2019-02-05 |
| 1083179014 | Hope Clinic of Integrative Medicine, LLC | Anesthesiology | 208 W Chandler Heights Rd # 101, Chandler, AZ 85248-5065 | 2019-02-04 |
| 1083100812 | Phoenix Interventional Pain Management, Pllc | Anesthesiology | 3815 E Bell Rd Ste 3500a, Phoenix, AZ 85032 | 2018-07-04 |
| 1164916953 | Orion Pain Physicians Pllc | Anesthesiology | 10133 N 92nd St., Suite 102, Scottsdale, AZ 85258-4805 | 2018-06-15 |
| 1538661822 | Anesthesia Solution of Arizona, LLC | Anesthesiology | 1450 W Guadalupe Rd Ste 124, Gilbert, AZ 85233-3056 | 2018-03-02 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.