# MODERN AMBULATORY SURGERY CENTER, PC

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

## Provider details

- **NPI number:** 1982031936
- **Authorized official:** LESLIE DAUGHERTY (ADMINISTRATOR)
- **Authorized official phone:** (602) 265-8800

## Contact information

- **Practice address:** 4860 E BASELINE ROAD, SUITE 101, MESA, AZ 85206-4670
- **Practice address phone:** (602) 265-8800
- **Practice address fax:** (602) 265-8151
- **Mailing address:** 1301 E MCDOWELL RD, SUITE 100, PHOENIX, AZ 85006-2621
- **Mailing address phone:** (602) 265-8800
- **Mailing address fax:** (602) 265-8151

## Taxonomy

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

## Other

- **Enumeration date:** 10/07/2013
- **Last updated:** 10/07/2013