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General NPI Number Information
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NPI Number | 1538391479
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Entity Type | Organization
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Legal Business Name | CHAPARRAL SURGICAL SPECIALISTS.LTD
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Dates
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Enumeration Date | 08/11/2009
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Last Update Date | 08/11/2009
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Provider Practice Location Address
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Address Line | 4601 W BRYCE LN
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City | GLENDALE
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State | AZ
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Zip | 85301-1626
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Country | US
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Telephone | 623-939-8676
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Fax | 623-939-1193
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Provider Business Mailing Address
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Address Line | 4601 W BRYCE LN
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City | GLENDALE
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State | AZ
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Zip | 85301-1626
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Country | US
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Telephone | 623-939-8676
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Fax | 623-939-1193
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WAYNE LEROY WERTZ
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Credential | M.D.
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Telephone | 623-939-8676
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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