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General NPI Number Information
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NPI Number | 1144618943
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Entity Type | Organization
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Legal Business Name | DERMATOLOGY & SKIN SURGERY SPECIALISTS OF ARIZONA, LLC
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Dates
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Enumeration Date | 12/31/2014
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Last Update Date | 01/09/2015
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Provider Practice Location Address
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Address Line | 8415 N PIMA RD SUITE 212
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-4480
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Country | US
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Telephone | 480-434-6600
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Fax | 480-522-3528
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Provider Business Mailing Address
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Address Line | 8415 N PIMA RD SUITE 212
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-4480
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Country | US
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Telephone | 480-434-6600
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Fax | 480-522-3528
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | ANNE JAMES GOLDSBERRY
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Credential | MD
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Telephone | 949-233-5571
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 49128
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License Number State | AZ
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