Organization
EMPRISE SURGICAL ASSOCIATE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL DAVID MCREYNOLDS PA-C (PHYSICIAN ASSISTANT)
(480) 860-1045
Entity
Organization
Contact information
Practice address
7846 E VISTA BONITA DR, SCOTTSDALE, AZ 85255-4123
(480) 860-1045
(480) 664-8889
Mailing address
7846 E VISTA BONITA DR, SCOTTSDALE, AZ 85255-4123
(480) 860-1045
(480) 664-8889
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
1480
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
881062
—
AZ
Enumeration date
02/16/2007
Last updated
03/28/2016
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