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General NPI Number Information
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NPI Number | 1780163030
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Entity Type | Organization
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Legal Business Name | LARRY J. SANDERS, M.D., PLLC.
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Dates
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Enumeration Date | 08/08/2018
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Last Update Date | 08/08/2018
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Provider Practice Location Address
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Address Line | 8235 S PECAN GROVE CIR
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City | TEMPE
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State | AZ
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Zip | 85284-2311
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Country | US
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Telephone | 480-730-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 8235 S PECAN GROVE CIR
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City | TEMPE
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State | AZ
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Zip | 85284-2311
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Country | US
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Telephone | 480-730-0000
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN/MANAGER
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Name | LARRY J. SANDERS
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Credential | M.D.
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Telephone | 480-730-0000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 11070
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License Number State | AZ
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