Provider Demographics
NPI:1003888124
Name:ARIZONA ORTHOPAEDIC SPECIALISTS LTD
Entity Type:Organization
Organization Name:ARIZONA ORTHOPAEDIC SPECIALISTS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:MARVIN
Authorized Official - Last Name:LAMPERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-870-5355
Mailing Address - Street 1:1616 E MARYLAND AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-1302
Mailing Address - Country:US
Mailing Address - Phone:602-870-3355
Mailing Address - Fax:602-870-3044
Practice Address - Street 1:1616 E MARYLAND AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-1302
Practice Address - Country:US
Practice Address - Phone:602-870-3355
Practice Address - Fax:602-870-3044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ17314208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ0342510OtherBLUE CROSS BLUE SHIELD
D81491Medicare UPIN
AZ0342510OtherBLUE CROSS BLUE SHIELD