Organization
SOUTHWEST SKIN SPECIALISTS, LLC
Active
Organization
SOUTHWEST SKIN SPECIALISTS, LLC
Active
Other names
Southwest Skin Specialists, LTD /
Organization subpart
No
Provider details
NPI number
Authorized official
HOWARD J. LUBER M.D. (MEDICAL DIRECTOR)
(602) 494-1817
Entity
Organization
Contact information
Practice address
5010 E SHEA BLVD STE 130, SCOTTSDALE, AZ 85254-4709
(602) 494-1817
(602) 494-7103
Mailing address
11130 N TATUM BLVD, SUITE 100, PHOENIX, AZ 85028-1662
(602) 494-1817
(602) 494-7103
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
98010735
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
WMBJQ
MEDICARE ID
AZ
Enumeration date
09/29/2010
Last updated
12/11/2018
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