Basic Information
| Provider Information | |||||||||
| NPI: | 1821643248 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MOUNTAIN ANESTHESIA PROVIDERS PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8924 E PINNACLE PEAK RD STE G5166 | ||||||||
| Address2: | |||||||||
| City: | SCOTTSDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852553618 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7242123097 | ||||||||
| FaxNumber: | 7342123114 | ||||||||
| Practice Location | |||||||||
| Address1: | 14416 W MEEKER BLVD STE 103 | ||||||||
| Address2: | |||||||||
| City: | SUN CITY | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853755284 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6238763870 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/02/2019 | ||||||||
| LastUpdateDate: | 08/02/2019 | ||||||||
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| AuthorizedOfficialLastName: | PERRY | ||||||||
| AuthorizedOfficialFirstName: | ERIC | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2487902080 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | DO | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.