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General NPI Number Information
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NPI Number | 1710168083
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Entity Type | Organization
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Legal Business Name | SCOTTSDALE SURGICAL CONSULTANTS PC
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Dates
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Enumeration Date | 11/15/2007
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Last Update Date | 11/27/2007
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Provider Practice Location Address
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Address Line | 3501 N SCOTTSDALE RD SUITE 234
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-5648
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Country | US
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Telephone | 480-421-1991
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Fax | 480-421-1996
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Provider Business Mailing Address
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Address Line | 3501 N SCOTTSDALE RD SUITE 234
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-5648
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Country | US
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Telephone | 480-421-1991
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Fax | 480-421-1996
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. TOM ALAN WOLVOS
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Credential | MD
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Telephone | 480-421-1991
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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 | 27673
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License Number State | AZ
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