# ARIZONA CENTER FOR MINIMALLY INVASIVE SURGERY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164794772
- **Authorized official:** DR. L PHILIPP WALL MD (OWNER)
- **Authorized official phone:** (623) 544-7266

## Contact information

- **Practice address:** 1475 W CHANDLER BLVD, CHANDLER, AZ 85224-6257
- **Practice address phone:** (623) 544-7266
- **Practice address fax:** (623) 321-1965
- **Mailing address:** 15571 N REEMS RD, SURPRISE, AZ 85374-9584
- **Mailing address phone:** (623) 544-7266
- **Mailing address fax:** (623) 321-1965

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 34753 | AZ | Yes |

## Other

- **Enumeration date:** 01/30/2012
- **Last updated:** 09/18/2014