Healthcare Provider Details

I. General information

NPI: 1326015728
Provider Name (Legal Business Name): ELENA SIBLEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/03/2006
Last Update Date: 12/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9977 N 90TH ST STE 178
SCOTTSDALE AZ
85258-4426
US

IV. Provider business mailing address

9977 N 90TH ST STE 178
SCOTTSDALE AZ
85258-4426
US

V. Phone/Fax

Practice location:
  • Phone: 480-947-7401
  • Fax: 480-946-5565
Mailing address:
  • Phone: 480-947-7401
  • Fax: 480-946-5565

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number21357
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: