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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