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General NPI Number Information
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NPI Number | 1740681733
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Entity Type | Organization
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Legal Business Name | SURGCENTER OF GREATER PHOENIX, LLC
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Dates
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Enumeration Date | 09/09/2014
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Last Update Date | 01/02/2015
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Provider Practice Location Address
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Address Line | 7231 E PRINCESS BLVD SUITE 100
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-9671
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Country | US
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Telephone | 480-423-4705
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Fax | 480-423-4706
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Provider Business Mailing Address
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Address Line | 7231 E PRINCESS BLVD SUITE 100
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-9671
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Country | US
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Telephone | 480-423-4705
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | STEFAN TARLOW
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Credential | M.D.
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Telephone | 480-423-4705
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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 |
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License Number State |
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