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General NPI Number Information
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NPI Number | 1578734257
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Entity Type | Organization
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Legal Business Name | ABDOMINAL SURGEONS,LTD
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Dates
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Enumeration Date | 03/20/2008
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Last Update Date | 10/13/2020
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Provider Practice Location Address
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Address Line | 1310 N 24TH ST STE 100
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City | PHOENIX
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State | AZ
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Zip | 85008-4617
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Country | US
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Telephone | 602-252-1510
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Fax | 602-256-9488
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Provider Business Mailing Address
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Address Line | 10810 N TATUM BLVD STE 102306
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City | PHOENIX
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State | AZ
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Zip | 85028-0503
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Country | US
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Telephone | 602-252-1510
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HILARIO JUAREZ
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Credential | M.D.
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Telephone | 602-252-1510
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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 | 12148
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License Number State | AZ
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