Healthcare Provider Details

I. General information

NPI: 1598016727
Provider Name (Legal Business Name): ELENA SIBLEY M.D. P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2012
Last Update Date: 09/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3604 N WELLS FARGO AVE STE. L
SCOTTSDALE AZ
85251-5629
US

IV. Provider business mailing address

3604 N WELLS FARGO AVE STE. L
SCOTTSDALE AZ
85251-5629
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: DR. ELENA SIBLEY
Title or Position: OWNER
Credential: M.D.
Phone: 480-947-7401