Healthcare Provider Details

I. General information

NPI: 1336687326
Provider Name (Legal Business Name): ARROWHEAD SURGERY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

1500 W RAY RD
CHANDLER AZ
85224-0002
US

IV. Provider business mailing address

1500 W RAY RD
CHANDLER AZ
85224-0002
US

V. Phone/Fax

Practice location:
  • Phone: 480-963-3881
  • Fax: 480-899-8610
Mailing address:
  • Phone: 480-963-3881
  • Fax: 480-899-8610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. MICHAEL JEROME DEPENBUSCH
Title or Position: PRESIDENT/OWNER
Credential: M.D.
Phone: 480-272-2686