Organization · NPI-2

Arizona Surgical Assistants, LLC

Physician Assistant, Surgical · Glendale, AZ

NPI number1265848105
StatusActive
Last updated in NPPESDec 19, 2014

Details

NPI
1265848105
Entity type
Organization (NPI-2)
Legal business name
Arizona Surgical Assistants, LLC
Organization subpart
No
Enumeration date
Jul 10, 2014
Last updated
Dec 19, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363AS0400X Physician Assistant, Surgical3740AZYes

Practice location

5555 W Thunderbird Rd
Glendale, AZ 85306-4622

Phone 623-865-5555 · Fax 480-478-6628

Mailing address

8424 E Shea Blvd
#101
Scottsdale, AZ 85260-6662

Phone 480-256-1518 · Fax 480-478-6628

Authorized official

Mark Mitchell
Owner/Manager
4802561518

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