Provider Demographics
NPI:1053590869
Name:MOUNTAIN VIEW SURGICAL ASSOCIATES PC
Entity type:Organization
Organization Name:MOUNTAIN VIEW SURGICAL ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:E
Authorized Official - Last Name:MCCUAIG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-827-7979
Mailing Address - Street 1:PO BOX 53347
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85072-3347
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6242 E ARBOR AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-1309
Practice Address - Country:US
Practice Address - Phone:480-827-7979
Practice Address - Fax:480-654-7173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-29
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ020048072OtherRAILROAD MEDICARE
AZ020048072OtherRAILROAD MEDICARE
AZ62977Medicare PIN