Healthcare Provider Details

I. General information

NPI: 1851736763
Provider Name (Legal Business Name): MATTHEW SNYDER LAFFER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2013
Last Update Date: 02/01/2021
Certification Date: 02/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8817 E BELL RD STE 101
SCOTTSDALE AZ
85260-1589
US

IV. Provider business mailing address

8817 E BELL RD STE 101
SCOTTSDALE AZ
85260-1589
US

V. Phone/Fax

Practice location:
  • Phone: 602-264-9044
  • Fax: 602-264-0057
Mailing address:
  • Phone: 602-264-9044
  • Fax: 602-264-0057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number59009
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number008851
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: