Provider Demographics
NPI:1578734257
Name:ABDOMINAL SURGEONS,LTD
Entity Type:Organization
Organization Name:ABDOMINAL SURGEONS,LTD
Other - Org Name:ADOMINAL SURGEONS,LTD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HILARIO
Authorized Official - Middle Name:
Authorized Official - Last Name:JUAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-252-1510
Mailing Address - Street 1:10810 N TATUM BLVD STE 102306
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-0503
Mailing Address - Country:US
Mailing Address - Phone:602-252-1510
Mailing Address - Fax:
Practice Address - Street 1:1310 N 24TH ST STE 100
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85008-4617
Practice Address - Country:US
Practice Address - Phone:602-252-1510
Practice Address - Fax:602-256-9488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-20
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ12148208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZC99711Medicare UPIN