Provider Demographics
NPI:1891851689
Name:SCOTTSDALE NEUROLOGY PLLC
Entity type:Organization
Organization Name:SCOTTSDALE NEUROLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEUROLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:SETH
Authorized Official - Middle Name:M
Authorized Official - Last Name:KAUFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD MPH
Authorized Official - Phone:480-621-3313
Mailing Address - Street 1:9755 N 90TH ST
Mailing Address - Street 2:SUITE A200
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-5046
Mailing Address - Country:US
Mailing Address - Phone:480-621-3313
Mailing Address - Fax:480-621-3314
Practice Address - Street 1:9755 N 90TH ST
Practice Address - Street 2:SUITE A200
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5046
Practice Address - Country:US
Practice Address - Phone:480-621-3313
Practice Address - Fax:480-621-3314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ113118Medicare PIN