MEDICARE: SCOTTSDALE OBSTETRICS & GYNECOLOGY, P. C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	29095	AZ

General Provider Information

NPI Number	:	1790953438
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCOTTSDALE OBSTETRICS & GYNECOLOGY, P. C.

Provider Business Mailing Address
First Line	:	10210 N 92ND ST STE 306
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85258-4525
Country	:	US
Telephone Number	:	480-945-4849
Fax Number	:	480-945-0989

Provider Business Practice Location Address
First Line	:	10210 N 92ND ST STE 306
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85258-4525
Country	:	US
Telephone Number	:	480-945-4849
Fax Number	:	480-945-0989

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. CAREY KERBY
Credential	:
Telephone Number	:	480-945-4849

Provider Enumeration Date	:	02/15/2008
Last Update Date	:	06/12/2023

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