Provider Demographics
NPI:1114968989
Name:GENERAL SURGERY OF PAYSON PLLC
Entity Type:Organization
Organization Name:GENERAL SURGERY OF PAYSON PLLC
Other - Org Name:SAN TAN GENERAL SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:LEROY
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:480-353-9438
Mailing Address - Street 1:726 N GREENFIELD RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-5061
Mailing Address - Country:US
Mailing Address - Phone:480-926-3353
Mailing Address - Fax:480-926-3362
Practice Address - Street 1:726 N GREENFIELD RD
Practice Address - Street 2:SUITE 105
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-5061
Practice Address - Country:US
Practice Address - Phone:480-296-3353
Practice Address - Fax:480-296-3362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2016-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty