Healthcare Provider Details

I. General information

NPI: 1144739079
Provider Name (Legal Business Name): FOUR PEAKS ANESTHESIA CONSULTANTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2017
Last Update Date: 12/02/2024
Certification Date: 12/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

868 E LIBRA PL
CHANDLER AZ
85249-3641
US

IV. Provider business mailing address

2040 S ALMA SCHOOL RD # 1-488
CHANDLER AZ
85286-7075
US

V. Phone/Fax

Practice location:
  • Phone: 480-757-0707
  • Fax: 602-391-2012
Mailing address:
  • Phone: 480-757-0707
  • Fax: 602-391-2012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207LA0401X
TaxonomyAddiction Medicine (Anesthesiology) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: SCOTT LEFFLER
Title or Position: OWNER
Credential:
Phone: 480-757-0707