Healthcare Provider Details

I. General information

NPI: 1285412320
Provider Name (Legal Business Name): PHOENIX UNIFIED SURGEONS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2023
Last Update Date: 03/02/2025
Certification Date: 03/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20333 N 19TH AVE STE 230
PHOENIX AZ
85027-9901
US

IV. Provider business mailing address

PO BOX 10356
GLENDALE AZ
85318-0356
US

V. Phone/Fax

Practice location:
  • Phone: 480-707-9504
  • Fax: 602-581-7764
Mailing address:
  • Phone: 602-421-1299
  • Fax: 602-581-7764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. DEBORA J FOX-MCCLARY
Title or Position: MANAGING PARTNER
Credential: MD, MBA, FACS, FASCR
Phone: 602-421-1299