Healthcare Provider Details

I. General information

NPI: 1639008493
Provider Name (Legal Business Name): WOUND SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9039 S SAN PABLO DR
GOODYEAR AZ
85338-7003
US

IV. Provider business mailing address

9039 S SAN PABLO DR
GOODYEAR AZ
85338-7003
US

V. Phone/Fax

Practice location:
  • Phone: 279-242-2227
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID BERGAY
Title or Position: OWNER
Credential:
Phone: 279-242-2227