Provider Demographics
NPI:1063221299
Name:BRIAN S. PAGE D.O. P.L.L.C.
Entity type:Organization
Organization Name:BRIAN S. PAGE D.O. P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:AJ
Authorized Official - Middle Name:
Authorized Official - Last Name:SAULNIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-295-4916
Mailing Address - Street 1:20325 N 51ST AVE STE 160
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-4622
Mailing Address - Country:US
Mailing Address - Phone:623-466-6350
Mailing Address - Fax:602-358-8698
Practice Address - Street 1:9620 N METRO PKWY W STE 143
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85051-1441
Practice Address - Country:US
Practice Address - Phone:623-466-6350
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BRIAN S. PAGE D.O. P.L.L.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-01-02
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty