Provider Demographics
NPI:1700116621
Name:STEPHEN R. ROSENTHAL MD PC
Entity Type:Organization
Organization Name:STEPHEN R. ROSENTHAL MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPEHN
Authorized Official - Middle Name:RRICHARD
Authorized Official - Last Name:ROSENTHAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-661-4200
Mailing Address - Street 1:10210 N 92ND ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4509
Mailing Address - Country:US
Mailing Address - Phone:480-661-4200
Mailing Address - Fax:480-657-2825
Practice Address - Street 1:10210 N 92ND ST
Practice Address - Street 2:SUITE 103
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4509
Practice Address - Country:US
Practice Address - Phone:480-661-4200
Practice Address - Fax:480-657-2825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-29
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0085820208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty