Healthcare Provider Details

I. General information

NPI: 1730305335
Provider Name (Legal Business Name): SCOTTSDALE UROLOGIC SURGEONS, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 06/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7301 E 2ND ST STE 308
SCOTTSDALE AZ
85251-5600
US

IV. Provider business mailing address

7301 E 2ND ST STE 308
SCOTTSDALE AZ
85251-5600
US

V. Phone/Fax

Practice location:
  • Phone: 480-949-1212
  • Fax: 480-994-5633
Mailing address:
  • Phone: 480-949-1212
  • Fax: 480-994-5633

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: MITCHELL CRAIG KAYE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 480-949-1212