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General NPI Number Information
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NPI Number | 1598700635
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Entity Type | Organization
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Legal Business Name | BARNET DULANEY SURGERY CENTER
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 11/17/2014
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Provider Practice Location Address
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Address Line | 1610 S WHITE MOUNTAIN RD
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City | SHOW LOW
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State | AZ
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Zip | 85901-7106
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Country | US
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Telephone | 602-955-1000
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Fax | 602-508-4830
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Provider Business Mailing Address
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Address Line | 4800 N 22ND ST
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City | PHOENIX
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State | AZ
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Zip | 85016-4701
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Country | US
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Telephone | 602-955-1000
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Fax | 602-508-4830
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Authorized Official
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Title or Position | CFO
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Name | DONALD SNYDER
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Credential |
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Telephone | 602-955-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 03C0001201
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License Number State | AZ
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