Layne C. Sandridge
Vascular Surgeon
18700 N 64th Dr Ste 105a
Glendale
, Arizona 85308-7110
Layne C. Sandridge
Vascular Surgeon
18700 N 64th Dr Ste 105a
Glendale
, Arizona 85308-7110
(623) 688-5075
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About
Features
Specialties
- Vascular Surgeon
Languages spoken
- English
Location
First Address
- Layne C. Sandridge
- 19801 N 59th Ave Unit 11659
- Glendale, AZ
- Zip : 85318-5068
- Fax : (623) 688-5075
- Phone : (623) 688-5075
Second Address
- Layne C. Sandridge
- 18700 N 64th Dr Ste 105a
- Glendale, AZ
- Zip : 85308-7110
- Fax : (623) 688-5075
- Phone : (623) 688-5075
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2086S0129X | Vascular Surgeon | 40861 | AZ |
National Provider Identifier
| NPI | 1063689909 |
|---|---|
| Provider Name | Layne C. Sandridge |
| First Address | Glendale, AZ 85318-5068 |
| Second Address | Glendale, AZ 85308-7110 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 09/05/2008 |
| Last Update Date | 04/01/2019 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 398159 | (05) | AZ |
| Z216660 | MEDICARE (01) | AZ |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.