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General NPI Number Information
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NPI Number | 1689874943
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Entity Type | Organization
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Legal Business Name | COCHISE SURGICAL CARE, PLLC
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Dates
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Enumeration Date | 07/24/2007
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Last Update Date | 12/13/2010
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Provider Practice Location Address
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Address Line | 75 COLONIA DE SALUD STE 100C
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City | SIERRA VISTA
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State | AZ
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Zip | 85635-2485
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Country | US
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Telephone | 520-452-0144
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Fax | 520-452-0075
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Provider Business Mailing Address
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Address Line | 75 COLONIA DE SALUD STE 100C
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City | SIERRA VISTA
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State | AZ
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Zip | 85635-2485
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Country | US
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Telephone | 520-452-0144
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Fax | 520-452-0075
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Authorized Official
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Title or Position | SURGEON
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Name | DR. ANNE HERBST
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Credential | MD
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Telephone | 520-452-0144
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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 | A41097
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License Number State | AZ
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