Healthcare Provider Details

I. General information

NPI: 1093368151
Provider Name (Legal Business Name): DESERT PEAKS SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2019
Last Update Date: 08/15/2023
Certification Date: 08/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1131 MALL DR STE A
LAS CRUCES NM
88011-8191
US

IV. Provider business mailing address

63 S ROCKFORD DR STE 220
TEMPE AZ
85288-6226
US

V. Phone/Fax

Practice location:
  • Phone: 575-288-4460
  • Fax: 575-288-4461
Mailing address:
  • Phone: 602-598-7025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ARTHUR BROOKFIELD
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 602-598-7488