Provider Demographics
NPI:1578387379
Name:SCOTTSDALE CLINIC, PLLC
Entity type:Organization
Organization Name:SCOTTSDALE CLINIC, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:NEUROSURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:NAKAJI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-313-7772
Mailing Address - Street 1:5744 N CANYON DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-2404
Mailing Address - Country:US
Mailing Address - Phone:602-317-5014
Mailing Address - Fax:
Practice Address - Street 1:7242 E OSBORN RD # 520
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6487
Practice Address - Country:US
Practice Address - Phone:602-313-7772
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-09
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty