Healthcare Provider Details

I. General information

NPI: 1740426485
Provider Name (Legal Business Name): ARIZONA UROLOGY SPECIALISTS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/31/2008
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20601 N. 19TH AVE SUITE 115
PHOENIX AZ
85027-2624
US

IV. Provider business mailing address

10200 GRAND CENTRAL AVE STE 220
OWINGS MILLS MD
21117-4366
US

V. Phone/Fax

Practice location:
  • Phone: 602-557-0007
  • Fax: 602-557-0001
Mailing address:
  • Phone: 602-222-1900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State

VIII. Authorized Official

Name: GEOFFREY SKLAR
Title or Position: SOLE PROPRIETOR
Credential: MD
Phone: 602-222-1900