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General NPI Number Information
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NPI Number | 1831511815
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Entity Type | Organization
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Legal Business Name | SWPT ANESTHESIA PC
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Dates
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Enumeration Date | 01/10/2014
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Last Update Date | 04/15/2016
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Provider Practice Location Address
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Address Line | 14301 N 87TH ST SUITE 102
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-3686
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Country | US
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Telephone | 480-351-8188
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Fax | 480-351-8187
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Provider Business Mailing Address
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Address Line | 14301 N 87TH ST SUITE 102
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-3686
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Country | US
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Telephone | 480-351-8188
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Fax | 480-351-8187
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | DR. MARNA RACENE HARRIS
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Credential | M.D.
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Telephone | 480-351-8188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 43522
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License Number State | AZ
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