Organization
PHOENIX ENDOSCOPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY SNODGRASS (PRESIDENT)
(615) 665-1283
Entity
Organization
Contact information
Practice address
349 EAST CORONADO ROAD, PHOENIX, AZ 85004-1525
(602) 266-5678
(602) 264-5646
Mailing address
1A BURTON HILLS BLVD # L&C, NASHVILLE, TN 37215-6187
(615) 240-3820
(615) 234-1720
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
OSC3462
AZ
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AZ0209110
BCBS IDENTIFICATION
AZ
Enumeration date
04/16/2007
Last updated
09/12/2022
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