Provider Demographics
NPI:1821643248
Name:MOUNTAIN ANESTHESIA PROVIDERS PC
Entity Type:Organization
Organization Name:MOUNTAIN ANESTHESIA PROVIDERS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:248-790-2080
Mailing Address - Street 1:8924 E PINNACLE PEAK RD STE G5166
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-3618
Mailing Address - Country:US
Mailing Address - Phone:724-212-3097
Mailing Address - Fax:734-212-3114
Practice Address - Street 1:14416 W MEEKER BLVD STE 103
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85375-5284
Practice Address - Country:US
Practice Address - Phone:623-876-3870
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-02
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty