Organization
SCOTTSDALE PEDIATRIC CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELLE WALLACE M.D. (PHYSICIAN)
(480) 860-1161
Entity
Organization
Contact information
Practice address
10200 N 92ND ST, SUITE 120, SCOTTSDALE, AZ 85258-4534
(480) 860-1161
(480) 860-6561
Mailing address
10200 N 92ND ST, SUITE 120, SCOTTSDALE, AZ 85258-4534
(480) 860-1161
(480) 860-6561
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
04/06/2007
Last updated
08/22/2020
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