Healthcare Provider Details
I. General information
NPI: 1457242455
Provider Name (Legal Business Name): EAST THOMAS SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/09/2025
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2629 N SCOTTSDALE RD STE 100
SCOTTSDALE AZ
85257-1370
US
IV. Provider business mailing address
16390 N 59TH AVE STE 200
GLENDALE AZ
85306-1711
US
V. Phone/Fax
- Phone: 623-334-4000
- Fax: 623-334-4400
- Phone: 623-334-4000
- Fax: 623-334-4400
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
DREW
MARKELL
Title or Position: CEO
Credential:
Phone: 623-334-4000