Organization
PHOENIX HEART AMBULATORY SURGERY AND ELECTROPHYSIOLOGY, LLC
Active
Other names
PHASE Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY VAN HORN (CENTER DIRECTOR)
(602) 806-0357
Entity
Organization
Contact information
Practice address
5859 W TALAVI BLVD STE 140, GLENDALE, AZ 85306-1871
(602) 806-0357
(623) 930-6060
Mailing address
5859 W TALAVI BLVD STE 140, GLENDALE, AZ 85306-1871
(602) 806-0357
(623) 930-6060
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
—
207RI0011X
Interventional Cardiology Physician
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
04/27/2021
Last updated
02/06/2023
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