Healthcare Provider Details

I. General information

NPI: 1982793410
Provider Name (Legal Business Name): AFFILIATED COLON AND RECTAL SURGEONS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 03/09/2020
Certification Date: 03/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1331 N 7TH ST STE 275
PHOENIX AZ
85006-2769
US

IV. Provider business mailing address

1331 N 7TH ST STE 275
PHOENIX AZ
85006-2769
US

V. Phone/Fax

Practice location:
  • Phone: 602-252-7004
  • Fax: 602-252-6232
Mailing address:
  • Phone: 602-252-7004
  • Fax: 602-252-6232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN E BROWN
Title or Position: PRESIDENT
Credential: MD
Phone: 602-252-7004