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General NPI Number Information
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NPI Number | 1720199607
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Entity Type | Organization
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Legal Business Name | SOUTHWEST SURGERY OF YAVAPAI COUNTY, PC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 04/14/2011
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Provider Practice Location Address
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Address Line | 2001 EXCELLENCE WAY SUITE 200
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City | PRESCOTT
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State | AZ
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Zip | 86301-8410
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Country | US
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Telephone | 928-445-3055
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Fax | 928-445-4732
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Provider Business Mailing Address
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Address Line | 2001 EXCELLENCE WAY SUITE 200
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City | PRESCOTT
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State | AZ
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Zip | 86301-8410
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Country | US
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Telephone | 928-445-3055
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Fax | 928-445-4732
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | DR. BRIAN P SCHILPEROORT
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Credential | M.D.
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Telephone | 928-445-3055
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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 | 25877
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License Number State | AZ
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