Healthcare Provider Details

I. General information

NPI: 1578027355
Provider Name (Legal Business Name): ARIZONA OUTPATIENT ANESTHESIA CONSULTANTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2019
Last Update Date: 01/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 E MCDOWELL RD STE 100
PHOENIX AZ
85006-2605
US

IV. Provider business mailing address

9977 N 90TH ST STE 350
SCOTTSDALE AZ
85258-4434
US

V. Phone/Fax

Practice location:
  • Phone: 480-207-1835
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: ADAM LERNER
Title or Position: GENERAL COUNSEL
Credential:
Phone: 480-245-6151