Provider Demographics
NPI:1477911980
Name:PHYSICIANS SURGICAL CENTER, LLC
Entity Type:Organization
Organization Name:PHYSICIANS SURGICAL CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NIKESH
Authorized Official - Middle Name:
Authorized Official - Last Name:SETH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-295-6578
Mailing Address - Street 1:7102 E ACOMA DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-2771
Mailing Address - Country:US
Mailing Address - Phone:480-444-8364
Mailing Address - Fax:602-773-0376
Practice Address - Street 1:7102 E ACOMA DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-2771
Practice Address - Country:US
Practice Address - Phone:480-444-8364
Practice Address - Fax:602-773-0376
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-29
Last Update Date:2018-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical