Healthcare Provider Details

I. General information

NPI: 1831324383
Provider Name (Legal Business Name): SCOTTSDALE ACUTE CARE SURGERY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2009
Last Update Date: 07/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9250 N 3RD ST SUITE 3000
PHOENIX AZ
85020-2437
US

IV. Provider business mailing address

16211 N SCOTTSDALE RD SUITE A6A #621
SCOTTSDALE AZ
85254-1584
US

V. Phone/Fax

Practice location:
  • Phone: 480-619-7227
  • Fax:
Mailing address:
  • Phone: 480-619-7227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number40382
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number40382
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number40382
License Number StateAZ

VIII. Authorized Official

Name: DR. STEPHEN GALE
Title or Position: PRESIDENT
Credential: MD
Phone: 480-619-7227