Provider Demographics
NPI:1518785393
Name:BILTMORE SURGICAL PARTNERS, LLC
Entity type:Organization
Organization Name:BILTMORE SURGICAL PARTNERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO, EVP
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-706-9900
Mailing Address - Street 1:19646 N 27TH AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-4025
Mailing Address - Country:US
Mailing Address - Phone:602-633-3061
Mailing Address - Fax:
Practice Address - Street 1:19646 N 27TH AVE STE 101
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-4025
Practice Address - Country:US
Practice Address - Phone:602-633-3061
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty