Organization
WYATT SURGERY CENTER LLC
Active
Other names
Wyatt Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL C DIESENHOUSE MD (MANAGER)
(520) 815-5050
Entity
Organization
Contact information
Practice address
2424 N WYATT DR STE 160, TUCSON, AZ 85712-6115
(334) 314-6079
Mailing address
5240 E KNIGHT DR STE 104, TUCSON, AZ 85712-2183
(520) 815-5050
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
—
—
261QS0132X
Ophthalmologic Surgery Clinic/Center
Primary
—
—
Other
Enumeration date
04/05/2019
Last updated
05/19/2021
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