Provider Demographics
NPI:1043238744
Name:OROZCO, CHARLES R (MD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:R
Last Name:OROZCO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4250 E CAMELBACK ROAD
Mailing Address - Street 2:SUITE K-250
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-8301
Mailing Address - Country:US
Mailing Address - Phone:602-253-9026
Mailing Address - Fax:602-252-6391
Practice Address - Street 1:4250 E CAMELBACK
Practice Address - Street 2:SUITE K-250
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-8301
Practice Address - Country:US
Practice Address - Phone:602-253-9026
Practice Address - Fax:602-252-6391
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ19458207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ3343879001OtherCIGNA
AZ003244Medicaid
AZAZ0350110OtherBCBS
AZ63071Medicare PIN
AZ3343879001OtherCIGNA