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SMITH TRYON FAMILY HEALTH INC D.B.A. BLUE WATER MEDICAL
NPI 1336104462
Family Medicine in Lake Havasu City, AZ

Active since April 20, 2006
1801 MESQUITE AVE, LAKE HAVASU CITY, AZ 86403(928) 453-6963(928) 453-7015 Get Directions Write a Review

NPPES record last updated: September 27, 2010. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Smith Tryon Family Health Inc D.b.a. Blue Water Medical NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SMITH TRYON FAMILY HEALTH INC D.B.A. BLUE WATER MEDICAL (NPI 1336104462) is a healthcare organization registered as a family medicine in Lake Havasu City, Arizona and active in the NPI registry since April 2006. The organization lists Elizabeth Anne Smith Tryon, President, as its authorized official.

NPPES Registry Identity

NPI1336104462
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSMITH TRYON FAMILY HEALTH INC D.B.A. BLUE WATER MEDICAL
Location Address1801 MESQUITE AVELake Havasu City, AZ 86403-5664
Mailing Address1990 Mcculloch Blvd N, Suite D, Box 379dLake Havasu City, AZ 86403-5749 · (928) 453-6963 · Fax (928) 453-7015
Phone(928) 453-6963
Fax(928) 453-7015
Organization SubpartNo
Authorized OfficialElizabeth Anne Smith TryonPresident · (928) 453-6963
Enumeration DateApril 20, 2006
Last NPPES UpdateSeptember 27, 2010
✔ NPI 1336104462 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in AZ · 35026
Definition
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.
Also ListedInternal MedicineTaxonomy 207R00000X · License 35026 (AZ)
Also ListedGeneral PracticeTaxonomy 208D00000X · License 2768 (AZ)
1801 MESQUITE AVE, Lake Havasu City, AZ 86403
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Other Identifiers 1

Medicare PINZ109244AZ

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FREDERIC LUO, MD, MSEE, INC
Internal Medicine
1801 MESQUITE AVE, SUITE 102
LAKE HAVASU CITY, AZ 86403
Mohave County (480) 888-1900
SIPONG PATAMASUCON
Physician Assistant
1801 MESQUITE AVE
LAKE HAVASU CITY, AZ 86403
Mohave County (928) 854-5400
ALICE DREYFUS APRN, FNP-BC
Nurse Practitioner (Family)
1801 MESQUITE AVE
LAKE HAVASU CITY, AZ 86403
Mohave County (928) 854-5400
DR. TEJASWI VENKATA MUDIGONDA M.D.
Dermatology (MOHS-Micrographic Surgery)
1801 MESQUITE AVE
LAKE HAVASU CITY, AZ 86403
Mohave County (928) 854-5400

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Smith Tryon Family Health Inc D.B.A. Blue Water Medical's NPI number?

The NPI number for Smith Tryon Family Health Inc D.B.A. Blue Water Medical is 1336104462. It was assigned to this organization in the NPPES registry on April 20, 2006.

Where is Smith Tryon Family Health Inc D.B.A. Blue Water Medical located?

Smith Tryon Family Health Inc D.B.A. Blue Water Medical is located at 1801 Mesquite Ave, Lake Havasu City, AZ 86403. The listed phone number is (928) 453-6963.

What is Smith Tryon Family Health Inc D.B.A. Blue Water Medical's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Smith Tryon Family Health Inc D.B.A. Blue Water Medical was last updated on September 27, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.