Provider Demographics
NPI:1285412320
Name:PHOENIX UNIFIED SURGEONS PLLC
Entity type:Organization
Organization Name:PHOENIX UNIFIED SURGEONS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORA
Authorized Official - Middle Name:J
Authorized Official - Last Name:FOX-MCCLARY
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MBA, FACS, FASCR
Authorized Official - Phone:602-421-1299
Mailing Address - Street 1:PO BOX 10356
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85318-0356
Mailing Address - Country:US
Mailing Address - Phone:602-421-1299
Mailing Address - Fax:602-581-7764
Practice Address - Street 1:20333 N 19TH AVE STE 230
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-9901
Practice Address - Country:US
Practice Address - Phone:480-707-9504
Practice Address - Fax:602-581-7764
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-19
Last Update Date:2025-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical OncologyGroup - Multi-Specialty
No208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Multi-Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
No261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatricGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ333524Medicaid