Organization
STANDARD SURGICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLIOT STEADMAN (SOLE MEMBER)
(801) 647-5158
Entity
Organization
Contact information
Practice address
5115 N DYSART RD STE 202-197, LITCHFIELD PARK, AZ 85340-3032
(801) 647-5158
Mailing address
PO BOX 29650, DEPT 880187, PHOENIX, AZ 85038-9650
(801) 647-5158
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
291199
—
AZ
Enumeration date
03/05/2017
Last updated
04/20/2018
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