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General NPI Number Information
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NPI Number | 1417019787
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Entity Type | Organization
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Legal Business Name | LIFESCAPE MEDICAL ASSOCIATES
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 12/04/2009
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Provider Practice Location Address
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Address Line | 8757 E BELL RD
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-1322
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Country | US
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Telephone | 480-860-5500
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Fax | 480-860-5260
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Provider Business Mailing Address
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Address Line | 8757 E BELL RD
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-1322
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Country | US
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Telephone | 480-860-5500
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Fax | 480-860-5260
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Authorized Official
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Title or Position | PHYSICIANS ASSISTANT
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Name | NORMAN J BIZON
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Credential | PA
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Telephone | 480-860-5500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number | 35591
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License Number State | AZ
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