Provider Demographics
NPI:1124200217
Name:SCOTTSDALE NEUROLOGICAL CONSULTANTS
Entity Type:Organization
Organization Name:SCOTTSDALE NEUROLOGICAL CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBI
Authorized Official - Middle Name:E
Authorized Official - Last Name:FOUTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-314-2099
Mailing Address - Street 1:9458 E IRONWOOD SQUARE DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4571
Mailing Address - Country:US
Mailing Address - Phone:480-314-2099
Mailing Address - Fax:480-314-2313
Practice Address - Street 1:9458 E IRONWOOD SQUARE DR
Practice Address - Street 2:SUITE 101
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4571
Practice Address - Country:US
Practice Address - Phone:480-314-2099
Practice Address - Fax:480-314-2313
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SCOTTSDALE NEUROLOGICAL CONSULTANTS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-11-29
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ62887Medicare PIN