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Organization

LEY INSTITUTE OF PLASTIC & HAND SURGERY, LLC

Active
Other names
Arizona Craniofacial & Pediatric Plastic Surgery
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ELEAZAR LEY TAI M.D. (OWNER/MANAGER)
(801) 651-8782
Entity
Organization

Contact information

Practice address
1517 N WILMOT RD, 177, TUCSON, AZ 85712-4410
(520) 396-3566
(801) 396-3548
Mailing address
5225 E KNIGHT DR, SUITE 201, TUCSON, AZ 85712-2156
(520) 396-3566
(801) 396-3548

Taxonomy

Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
36876
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
701121
AHCCCS
AZ
Enumeration date
07/17/2012
Last updated
07/17/2012
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