Healthcare Provider Details

I. General information

NPI: 1770862484
Provider Name (Legal Business Name): VEIN SPECIALISTS OF ARIZONA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2011
Last Update Date: 03/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9515 W CAMELBACK RD SUITE 108
PHOENIX AZ
85037-1355
US

IV. Provider business mailing address

9515 W CAMELBACK RD SUITE 108
PHOENIX AZ
85037-1355
US

V. Phone/Fax

Practice location:
  • Phone: 623-428-0068
  • Fax: 623-428-0069
Mailing address:
  • Phone: 623-428-0068
  • Fax: 623-428-0069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number3749
License Number StateAZ

VIII. Authorized Official

Name: DR. JEFFREY ALPERN
Title or Position: PRESIDENT
Credential: D.O.
Phone: 610-737-4445