Healthcare Provider Details
I. General information
NPI: 1356802573
Provider Name (Legal Business Name): SAZ CARE OF AZ, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/29/2019
Last Update Date: 03/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2155 W PINNACLE PEAK RD STE 201A
PHOENIX AZ
85027-1201
US
IV. Provider business mailing address
102 WOODMONT BLVD STE 350
NASHVILLE TN
37205-2216
US
V. Phone/Fax
- Phone: 615-386-0064
- Fax:
- Phone: 615-386-0064
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207XS0117X |
| Taxonomy | Orthopaedic Surgery of the Spine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
EDWARD
LELAND HUTTON
EADIE
Title or Position: DIRECTOR
Credential:
Phone: 615-733-2064