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General NPI Number Information
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NPI Number | 1285053702
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Entity Type | Organization
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Legal Business Name | PRECISION SURGICAL LLC
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Dates
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Enumeration Date | 04/11/2014
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Last Update Date | 10/17/2017
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Provider Practice Location Address
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Address Line | 4250 E CAMELBACK RD STE K105
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City | PHOENIX
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State | AZ
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Zip | 85018-8301
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Country | US
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Telephone | 602-559-9310
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Fax | 602-559-9311
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Provider Business Mailing Address
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Address Line | 8776 E SHEA BLVD STE 106-610
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-6687
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Country | US
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Telephone | 602-559-9310
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Fax | 602-559-9311
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RICHARD J CHAMBERLAIN III
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Credential | M.D.
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Telephone | 602-559-9310
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 22292
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License Number State | AZ
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