Provider Demographics
NPI:1760125074
Name:QUANTUM ANESTHESIOLOGY CONSULTANTS
Entity Type:Organization
Organization Name:QUANTUM ANESTHESIOLOGY CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MBR
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:D
Authorized Official - Last Name:SWEATLOCKK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-770-8613
Mailing Address - Street 1:PO BOX 15075
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85060-5075
Mailing Address - Country:US
Mailing Address - Phone:480-414-3077
Mailing Address - Fax:
Practice Address - Street 1:6790 W THUNDERBIRD RD
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-5023
Practice Address - Country:US
Practice Address - Phone:623-979-1717
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-14
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty