Provider Demographics
NPI:1770535742
Name:VATSAR FAIL, ERIKA L (MD)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:L
Last Name:VATSAR FAIL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12329 N 89TH PL
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-5061
Mailing Address - Country:US
Mailing Address - Phone:602-509-3234
Mailing Address - Fax:
Practice Address - Street 1:1420 E DOBSON ROAD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-4707
Practice Address - Country:US
Practice Address - Phone:480-276-1598
Practice Address - Fax:480-275-4495
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ30554207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ796998Medicaid
H82961Medicare UPIN
AZZ74530Medicare PIN