# UROLOGY ASC - PHOENIX, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Urologic Surgery Center of Arizona
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912571795
- **Authorized official:** SANFORD JAY SIEGEL MD (OWNER)
- **Authorized official phone:** (410) 581-1600

## Contact information

- **Practice address:** 16390 N 59TH AVE STE 100, GLENDALE, AZ 85306-1711
- **Practice address phone:** (602) 241-5105
- **Mailing address:** 25 CROSSROADS DR STE 306, OWINGS MILLS, MD 21117-5437
- **Mailing address phone:** (866) 953-3111
- **Mailing address fax:** (443) 471-8540

## Taxonomy

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

## Other

- **Enumeration date:** 05/17/2021
- **Last updated:** 05/17/2021