Provider Demographics
NPI:1790953438
Name:SCOTTSDALE OBSTETRICS & GYNECOLOGY, P. C.
Entity Type:Organization
Organization Name:SCOTTSDALE OBSTETRICS & GYNECOLOGY, P. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAREY
Authorized Official - Middle Name:
Authorized Official - Last Name:KERBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-945-4849
Mailing Address - Street 1:10210 N 92ND ST STE 306
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4525
Mailing Address - Country:US
Mailing Address - Phone:480-945-4849
Mailing Address - Fax:480-945-0989
Practice Address - Street 1:10210 N 92ND ST STE 306
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4525
Practice Address - Country:US
Practice Address - Phone:480-945-4849
Practice Address - Fax:480-945-0989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-15
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ29095207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ66272Medicare PIN
AZH41460Medicare UPIN