MEDICARE: COMPLEX NEUROLOGY LLC

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	2084N0400X	Neurology Physician

General Provider Information

NPI Number	:	1841763729
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPLEX NEUROLOGY LLC

Provider Business Mailing Address
First Line	:	6051 E CORTEZ DR
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85254-4948
Country	:	US
Telephone Number	:	602-900-9404
Fax Number	:

Provider Business Practice Location Address
First Line	:	1010 E MCDOWELL RD STE 101
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85006-2607
Country	:	US
Telephone Number	:	602-900-9404
Fax Number	:	602-903-6587

Authorized Official
Title or Position	:	MEMBER AND MANAGER
Name	:	DR. DAVID SCOTT SAPERSTEIN
Credential	:	MD
Telephone Number	:	602-697-0288

Provider Enumeration Date	:	01/03/2019
Last Update Date	:	07/10/2019

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