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General NPI Number Information
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NPI Number | 1992061162
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Entity Type | Organization
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Legal Business Name | ARIZONA DERMATOLOGY SPECIALISTS, PLLC
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Dates
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Enumeration Date | 04/02/2012
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Last Update Date | 09/04/2012
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Provider Practice Location Address
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Address Line | 14800 W. MOUNTAIN VIEW BLVD. STE. 160
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City | SURPRISE
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State | AZ
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Zip | 85374-2700
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Country | US
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Telephone | 623-584-3376
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Fax | 623-584-3375
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Provider Business Mailing Address
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Address Line | P.O. BOX 9290
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City | SURPRISE
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State | AZ
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Zip | 85374-9290
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Country | US
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Telephone | 623-584-3376
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Fax | 623-584-3375
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Authorized Official
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Title or Position | OWNER/MEMBER
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Name | JAMES O BARLOW
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Credential | M.D.
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Telephone | 602-793-8411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number | 29708
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 29708
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License Number State | AZ
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