Organization
VALLEY OF THE SUN SURGICAL DERMATOLOGY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LORA J PLATTNER MD (CEO)
(480) 998-1158
Entity
Organization
Contact information
Practice address
8406 E SHEA BLVD, SUITE 100, SCOTTSDALE, AZ 85260-6659
(480) 998-1158
(480) 998-0123
Mailing address
8406 E SHEA BLVD, STE 100, SCOTTSDALE, AZ 85260-6659
(480) 998-1158
(480) 998-0123
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
24109
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070013612
RAIL ROAD MEDICARE
AZ
01
—
349798
AHCCCS QMB
AZ
05
—
648438
—
AZ
Enumeration date
11/08/2007
Last updated
09/18/2015
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