Provider Demographics
NPI:1821471913
Name:ARIZONA SURGICAL SPECIALISTS CENTER, LLC
Entity Type:Organization
Organization Name:ARIZONA SURGICAL SPECIALISTS CENTER, LLC
Other - Org Name:ARIZONA SURGICAL SPECIALSTS CENTER WEST PHOENIX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SIWEK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:623-516-8252
Mailing Address - Street 1:5281 N 99TH AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85305-3105
Mailing Address - Country:US
Mailing Address - Phone:623-516-8252
Mailing Address - Fax:623-516-8253
Practice Address - Street 1:9250 W THOMAS RD
Practice Address - Street 2:SUITE 220
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-3382
Practice Address - Country:US
Practice Address - Phone:623-516-8252
Practice Address - Fax:623-516-8253
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARIZONA SURGICAL SPECIALISTS CENTER LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-07-07
Last Update Date:2019-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical