Provider Demographics
NPI:1033250618
Name:MCDOWELL AMBULATORY SURGERY CENTER LLC
Entity type:Organization
Organization Name:MCDOWELL AMBULATORY SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:TRAVIS
Authorized Official - Last Name:ADKINS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:602-265-8800
Mailing Address - Street 1:8805 N 23RD AVE STE 120
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-4149
Mailing Address - Country:US
Mailing Address - Phone:602-265-8800
Mailing Address - Fax:602-265-8151
Practice Address - Street 1:1301 E MCDOWELL RD
Practice Address - Street 2:SUITE 100
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2621
Practice Address - Country:US
Practice Address - Phone:602-265-8800
Practice Address - Fax:602-265-8151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ111804Medicare PIN