Healthcare Provider Details
I. General information
NPI: 1649546193
Provider Name (Legal Business Name): ACE ASSAF OVIL M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/29/2012
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
16601 N 40TH ST STE 204
PHOENIX AZ
85032-3356
US
IV. Provider business mailing address
16601 N 40TH ST STE 204
PHOENIX AZ
85032-3356
US
V. Phone/Fax
- Phone: 602-633-3721
- Fax: 602-595-1127
- Phone: 602-633-3721
- Fax: 602-953-5466
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | 56127 |
| License Number State | AZ |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0102X |
| Taxonomy | Surgical Critical Care Physician |
| License Number | 56127 |
| License Number State | AZ |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2086S0127X |
| Taxonomy | Trauma Surgery Physician |
| License Number | 56127 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: