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Individual

SYDNEY VAIL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2601 E ROOSEVELT ST, PHOENIX, AZ 85008-4973
(602) 344-5011
Mailing address
2929 E THOMAS RD, PHOENIX, AZ 85016-8034
(602) 470-5000

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
40934
AZ
2086S0127X
Trauma Surgery Physician
Primary
40934
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010019788
VA
05
010039827
VA
05
368509
AZ
05
5886481
VA
05
5886597
VA
05
5886619
VA
05
7307161
VA
Enumeration date
04/10/2006
Last updated
03/13/2017
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