Organization · Type 2 NPI
Phantom Surgical LLC
Surgical Physician Assistant · Phoenix, AZ
NPI number
1063386332
Active
Practice location
19820 N 7th St Ste 208
Phoenix, AZ 85024-1694
Mailing address
PO Box 41340
Phoenix, AZ 85080-1340
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Surgical Physician Assistant Primary | 363AS0400X | None listed |
Surgical Physician Assistant: Definition to come...
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About NPI 1063386332
Phantom Surgical LLC's National Provider Identifier is 1063386332, issued on Sep 30, 2025. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Phoenix, AZ. The record was last updated on Sep 30, 2025.