Provider Demographics
NPI:1033279161
Name:NORTH PHOENIX ORTHOPEDIC SURGEONS, LTD
Entity Type:Organization
Organization Name:NORTH PHOENIX ORTHOPEDIC SURGEONS, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THEODORE
Authorized Official - Middle Name:ROLAND
Authorized Official - Last Name:HOFSTEDT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-944-2271
Mailing Address - Street 1:9250 N 3RD ST
Mailing Address - Street 2:SUITE 4030
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-2412
Mailing Address - Country:US
Mailing Address - Phone:602-944-2271
Mailing Address - Fax:602-943-3420
Practice Address - Street 1:9250 N 3RD ST
Practice Address - Street 2:SUITE 4030
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-2412
Practice Address - Country:US
Practice Address - Phone:602-944-2271
Practice Address - Fax:602-943-3420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZWHCQHMedicare ID - Type UnspecifiedGROUP MEDICARE NUMBER