Provider Demographics
NPI:1114117710
Name:MCWHORTER, BRIAN ROBB (DO)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:ROBB
Last Name:MCWHORTER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10238 E HAMPTON AVE STE 301C
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85209-3322
Mailing Address - Country:US
Mailing Address - Phone:480-354-5900
Mailing Address - Fax:
Practice Address - Street 1:10238 E HAMPTON AVE STE 301C
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85209-3322
Practice Address - Country:US
Practice Address - Phone:480-354-5900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-30
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ005584207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery