MEDSPA BY SOUL SURGERY LLC NPI 1184104812

NPI Information

NPI: 1184104812
Provider Name: MEDSPA BY SOUL SURGERY, LLC
Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

Address:
14362 N FRANK LLOYD WRIGHT BLVD STE B109
SCOTTSDALE, AZ
ZIP 85260
Phone: (480) 912-3105
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MEDSPA BY SOUL SURGERY, LLC is a rehabilitation and substance use disorder clinic center in Scottsdale, AZ. MEDSPA BY SOUL SURGERY, LLC NPI is 1184104812. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

14362 N FRANK LLOYD WRIGHT BLVD STE B109
SCOTTSDALE, AZ
ZIP 85260-881
Phone: (480) 912-3105
Fax: (480) 912-3106

The provider's authorized official is Regina Shakespeare .
The authorized official title is Billing Compliance Officer and has the following contact phone number (928) 554-5633.

The enumeration date for this NPI number is 8/21/2018 and was last updated on 1/31/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207R00000X	Internal Medicine		XT4080190	ARIZONA	No
2	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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