Provider Demographics
NPI:1306278403
Name:ARIZONA COLORECTAL SURGERY PLLC
Entity type:Organization
Organization Name:ARIZONA COLORECTAL SURGERY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GARAND
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:480-947-3533
Mailing Address - Street 1:3501 N SCOTTSDALE RD STE 222
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-5649
Mailing Address - Country:US
Mailing Address - Phone:480-947-3533
Mailing Address - Fax:
Practice Address - Street 1:3501 N SCOTTSDALE RD STE 222
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-5649
Practice Address - Country:US
Practice Address - Phone:480-947-3533
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-31
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ005056208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty