Healthcare Provider Details

I. General information

NPI: 1457285272
Provider Name (Legal Business Name): MEDSCOPE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 E WASHINGTON ST 8TH FLOOR
PHOENIX AZ
85004
US

IV. Provider business mailing address

101 E WASHINGTON ST 8TH FLOOR
PHOENIX AZ
85004
US

V. Phone/Fax

Practice location:
  • Phone: 602-922-0522
  • Fax:
Mailing address:
  • Phone: 602-922-0522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number
License Number State

VIII. Authorized Official

Name: KASEY ROBERTSON
Title or Position: CAO
Credential: CHIEF ADMIN OFFICER
Phone: 210-422-4613