Healthcare Provider Details

I. General information

NPI: 1154326650
Provider Name (Legal Business Name): SCOTTSDALE SURGICAL PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2005
Last Update Date: 03/12/2021
Certification Date: 03/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 E. RAINTREE DR. SUITE 100
SCOTTSDALE AZ
85260
US

IV. Provider business mailing address

3033 N. 44TH ST. SUITE 330
PHOENIX AZ
85018
US

V. Phone/Fax

Practice location:
  • Phone: 480-767-2100
  • Fax:
Mailing address:
  • Phone: 480-207-3716
  • Fax: 623-266-0053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License NumberOSC3774
License Number StateAZ

VIII. Authorized Official

Name: BRIAN GIESSLER
Title or Position: VP OF OPERATIONS
Credential:
Phone: 480-207-3716