Provider Demographics
NPI:1689892788
Name:SCOTTSDALE CVT SURGEONS
Entity Type:Organization
Organization Name:SCOTTSDALE CVT SURGEONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:HIGHTOWER
Authorized Official - Last Name:WAREING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-947-7738
Mailing Address - Street 1:7301 E 2ND ST
Mailing Address - Street 2:SUITE #310
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-5600
Mailing Address - Country:US
Mailing Address - Phone:480-947-7738
Mailing Address - Fax:480-947-1712
Practice Address - Street 1:7301 E 2ND ST
Practice Address - Street 2:SUITE #310
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-5600
Practice Address - Country:US
Practice Address - Phone:480-947-7738
Practice Address - Fax:480-947-1712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ22417208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZA13853Medicare UPIN