Southwest Surgery, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

SOUTHWEST SURGERY, LLC

Practice address

1972 Mesquite Ave
Lake Havasu City, AZ 86403-5729

Phone

(928) 854-6500

Fax

(928) 854-6206

NPI assigned

Mar 1, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Carrie L Riesdorph

Title

Office Manager

Phone

(928) 854-6500

Specialties & licenses 1

Addresses

Tax ID family

Southwest Surgery LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Southwest Surgery, L.L.C.

  • Specialist
  • Lake Havasu City, AZ
  • NPI 1760568224
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164550950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1972 MESQUITE AVE",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035729",
            "telephone_number": "928-854-6500",
            "fax_number": "928-854-6206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1972 MESQUITE AVE",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035729",
            "telephone_number": "928-854-6500",
            "fax_number": "928-854-6206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST SURGERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RIESDORPH",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "928-854-6500"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edouard Sorkin, DDS
• Southwest Behavioral Health Services, Inc.
• Southwest Ear, Nose & Throat, PLLC
• Southwest Ear, Nose, & Throat Specialists
• Southwest Surgery, L.L.C.
• Rian William Spear, PHARMD
• Peter Walmy St Louis Angervil
• Yvonne St. John, RN
• Philip Andre' St. Raymond, MD
• Stability Mobilized, LLC

• Specialist in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• Specialist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.