Healthcare Provider Details

I. General information

NPI: 1528498029
Provider Name (Legal Business Name): DOBSON PROPERTY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2013
Last Update Date: 01/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

895 S DOBSON RD STE 3
CHANDLER AZ
85224-5721
US

IV. Provider business mailing address

5281 N 99TH AVE SUITE 100
GLENDALE AZ
85305-3105
US

V. Phone/Fax

Practice location:
  • Phone: 623-742-1571
  • Fax: 480-699-0578
Mailing address:
  • Phone: 623-742-1471
  • Fax: 623-691-8504

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License NumberOSC4418
License Number StateAZ

VII. Legacy identifiers

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

VIII. Authorized Official

Name: MRS. CATHY HARDESTY
Title or Position: DIRECTOR OF ADMIN OPS
Credential:
Phone: 623-241-6158