Organization
BLACK CANYON ANESTHESIA, PC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON WHITE (OFFICE MANAGER)
(602) 443-2325
Entity
Organization
Contact information
Practice address
7600 N 16TH ST, SUITE 150, PHOENIX, AZ 85020-4431
(602) 395-0718
(602) 277-8146
Mailing address
PO BOX 39179, PHOENIX, AZ 85069-9179
(602) 395-0718
(602) 277-8146
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
13308
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
239237
—
AZ
Enumeration date
06/26/2006
Last updated
08/12/2010
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