Organization
LAURENCE M SUSINI MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDY KAPLAN (CONTRACTS)
(520) 458-6331
Entity
Organization
Contact information
Practice address
155 CALLE PORTAL STE 100, SIERRA VISTA, AZ 85635-2900
(520) 458-6088
(520) 458-3983
Mailing address
155 CALLE PORTAL STE 100, SIERRA VISTA, AZ 85635-2900
(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
—
AZ0779560
BCBSAZ
AZ
Enumeration date
07/23/2006
Last updated
04/10/2008
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