Organization
LAYNE SANDRIDGE MD, PLC
Active
Organization
LAYNE SANDRIDGE MD, PLC
Active
Other names
Valley Vascular Specialists
Organization subpart
No
Provider details
NPI number
Authorized official
LAYNE C. SANDRIDGE MD (PHYSICIAN/PRACTICE OWNER)
(623) 688-5075
Entity
Organization
Contact information
Practice address
18700 N 64TH DR STE 105A, GLENDALE, AZ 85308-7110
(623) 688-5075
(623) 688-5075
Mailing address
19801 N 59TH AVE, #11659, GLENDALE, AZ 85318
(623) 688-5075
(602) 842-9970
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
443661
—
AZ
Enumeration date
01/23/2018
Last updated
03/21/2019
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