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General NPI Number Information
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NPI Number | 1538613096
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Entity Type | Organization
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Legal Business Name | ARIZONA SURGERY CONSULTANTS
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Dates
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Enumeration Date | 08/12/2016
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Last Update Date | 08/12/2016
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Provider Practice Location Address
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Address Line | 3104 E INDIAN SCHOOL RD STE 110
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City | PHOENIX
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State | AZ
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Zip | 85016-6873
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Country | US
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Telephone | 602-956-0484
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Fax | 602-956-0501
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Provider Business Mailing Address
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Address Line | 3104 E INDIAN SCHOOL RD STE 110
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City | PHOENIX
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State | AZ
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Zip | 85016-6873
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Country | US
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Telephone | 602-956-0484
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Fax | 602-956-0501
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Authorized Official
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Title or Position | VP OPERATIONS
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Name | GARY HOWLE
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Credential | MBHA
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Telephone | 904-956-0484
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number | OTC7296
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License Number State | AZ
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