Organization
BRIGHAM ANESTHESIA SPECIALISTS LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARRY THOMAS SALTS MD (PRESIDENT)
(602) 882-2106
Entity
Organization
Contact information
Practice address
1111 E MCDOWELL ROAD, BANNER GOOD SAMARITAN REGIONAL MEDICAL CENTER, PHOENIX, AZ 85006
(602) 239-2147
(602) 239-2581
Mailing address
PO BOX 15151, PHOENIX, AZ 85060-5151
(602) 882-2106
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
9138
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
227050
AHCCCS
AZ
Enumeration date
04/20/2006
Last updated
08/22/2020
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