Provider Demographics
NPI:1043272628
Name:OPIE, JOHN C (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:C
Last Name:OPIE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8575 E PRINCESS DR
Mailing Address - Street 2:SUITE 117
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-5483
Mailing Address - Country:US
Mailing Address - Phone:480-889-1961
Mailing Address - Fax:480-264-7012
Practice Address - Street 1:8575 E PRINCESS DR
Practice Address - Street 2:SUITE 117
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-5483
Practice Address - Country:US
Practice Address - Phone:480-889-1961
Practice Address - Fax:480-264-7012
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2012-11-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ19784208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0351090OtherBCBS
AZZ125741OtherMEDICARE PTAN
B32975Medicare UPIN
AZAZ0351090OtherBCBS