Healthcare Provider Details

I. General information

NPI: 1831717891
Provider Name (Legal Business Name): SATURN MEDICAL SPECIALISTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2020
Last Update Date: 07/07/2020
Certification Date: 07/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13660 N 94TH DRIVE STE D-1
PEORIA AZ
85381-8538
US

IV. Provider business mailing address

7558 W THUNDERBIRD RD SUITE 1-623
PEORIA AZ
85381-4836
US

V. Phone/Fax

Practice location:
  • Phone: 623-230-2912
  • Fax: 602-726-3605
Mailing address:
  • Phone: 623-230-2912
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. KEITH BANGART
Title or Position: MANAGER/PROVIDER
Credential: DPM
Phone: 623-230-2912