Organization
JCL SURGERY, LLC
Active
Other names
North Valley Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
GARY R GROVER (SR. VICE PRESIDENT)
(602) 216-6687
Entity
Organization
Contact information
Practice address
3201 W PEORIA AVE, SUITE C500, PHOENIX, AZ 85029-4608
(602) 298-6516
(602) 298-2347
Mailing address
3201 W PEORIA AVE, SUITE C500, PHOENIX, AZ 85029-4608
(602) 298-6516
(602) 298-2347
Taxonomy
Speciality
Code
Description
License number
State
2086S0127X
Trauma Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
093479
—
AZ
Enumeration date
06/03/2006
Last updated
11/29/2007
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