Organization
ARIZONA ADVANCED SURGICAL AND PAIN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNA MARIE FISHER (OFFICE MANAGER)
(602) 826-5090
Entity
Organization
Contact information
Practice address
5235 E SOUTHERN AVE STE D106-444, MESA, AZ 85206-3626
(480) 776-0041
(480) 776-0041
Mailing address
5235 E SOUTHERN AVE STE D106-444, MESA, AZ 85206-3626
(602) 826-5090
(480) 776-0046
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23075882
ARIZONA CORPORATE COMMISSION
AZ
Enumeration date
07/29/2020
Last updated
04/03/2023
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