Southwest Skin & Cancer Institute LTD

Primary specialty

Dermatopathology PhysicianTaxonomy code 207ND0900X

License

31062 Issued in AZ

Legal business name

SOUTHWEST SKIN & CANCER INSTITUTE LTD

Practice address

242 Whipple St
Prescott, AZ 86301-1787

Phone

(928) 778-0808

Fax

(928) 778-4788

NPI assigned

Oct 2, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Robin M Fleck, MD

Title

Owner/Sole Member

Phone

(928) 778-0808

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1443744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443744000000",
    "number": "1427428416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 WHIPPLE ST",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011787",
            "telephone_number": "928-778-0808",
            "fax_number": "928-778-4788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 WHIPPLE ST",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011787",
            "telephone_number": "928-778-0808",
            "fax_number": "928-778-4788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST SKIN & CANCER INSTITUTE LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-02",
        "last_updated": "2015-10-02",
        "status": "A",
        "authorized_official_last_name": "FLECK",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/SOLE MEMBER",
        "authorized_official_telephone_number": "928-778-0808",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": "AZ",
            "license": "31062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael J Sorensen, M.D.
• Dustin Sorkhpoosh, DO
• Southwest Behavioral Health Services, Inc.
• Southwest Center for Communication Disorders
• Southwest Skin & Cancer Institute
• Southwest Surgery of Yavapai County, PC
• Southwestern Eye Center LTD
• Southwestern Eye Center, LTD
• Southwestern Medical Centers Az
• Southwestern Medical Centers Inc - Az

• Dermatopathology Physician in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Dermatopathology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2015; 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.