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General NPI Number Information
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NPI Number | 1922335801
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Entity Type | Organization
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Legal Business Name | EAST VALLEY SURGERY CENTER, LLC
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Dates
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Enumeration Date | 11/12/2009
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Last Update Date | 09/19/2019
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Provider Practice Location Address
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Address Line | 1855 E SOUTHERN AVE
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City | TEMPE
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State | AZ
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Zip | 85282-5894
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Country | US
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Telephone | 480-829-6100
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Fax |
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Provider Business Mailing Address
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Address Line | 1855 E SOUTHERN AVE BLDG B
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City | TEMPE
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State | AZ
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Zip | 85282-5894
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Country | US
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Telephone | 480-829-6100
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL JOHN ORRIS
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Credential | D.O.
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Telephone | 480-829-6100
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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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