Individual
LAURENCE M SUSINI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
155 CALLE PORTAL, #100, SIERRA VISTA, AZ 85635
(520) 458-6088
(520) 458-3983
Mailing address
155 CALLE PORTAL, #100, SIERRA VISTA, AZ 85635
(520) 458-6088
(520) 458-3983
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
17611
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
284985
—
AZ
01
—
2Z2281
HEALTH NET
—
01
—
AZ0779560
BCBS AZ
—
Enumeration date
06/06/2006
Last updated
12/02/2009
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