Provider Demographics
NPI:1558599787
Name:SOUTHWESTERN NEUROSURGERY P.C.
Entity Type:Organization
Organization Name:SOUTHWESTERN NEUROSURGERY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:LAPRADE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-242-0299
Mailing Address - Street 1:9250 N 3RD ST
Mailing Address - Street 2:SUITE 3000
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-2412
Mailing Address - Country:US
Mailing Address - Phone:602-242-0299
Mailing Address - Fax:602-242-9429
Practice Address - Street 1:9250 N 3RD ST
Practice Address - Street 2:SUITE 3000
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-2412
Practice Address - Country:US
Practice Address - Phone:602-242-0299
Practice Address - Fax:602-242-9429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-25
Last Update Date:2009-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ13306207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty