Provider Demographics
NPI:1245002369
Name:ARIZONA CENTER FOR SURGICAL EXCELLENCE, LLC
Entity type:Organization
Organization Name:ARIZONA CENTER FOR SURGICAL EXCELLENCE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-222-5600
Mailing Address - Street 1:370 E VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85004-1214
Mailing Address - Country:US
Mailing Address - Phone:602-258-4788
Mailing Address - Fax:
Practice Address - Street 1:3329 E BELL RD STE A1A5
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-2756
Practice Address - Country:US
Practice Address - Phone:602-222-5600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical