Provider Demographics
NPI:1164495503
Name:NORTHERN ARIZONA ORTHOPAEDICS, LTD.
Entity Type:Organization
Organization Name:NORTHERN ARIZONA ORTHOPAEDICS, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REVENUE & REIMBURSEMENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:MUELLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-214-3233
Mailing Address - Street 1:1485 N TURQUOISE DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-1398
Mailing Address - Country:US
Mailing Address - Phone:928-774-7757
Mailing Address - Fax:928-774-7767
Practice Address - Street 1:1485 N TURQUOISE DR
Practice Address - Street 2:SUITE 200
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-1398
Practice Address - Country:US
Practice Address - Phone:928-774-7757
Practice Address - Fax:928-774-7767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ0706750001OtherDMERC
AZWCJBSMedicare UPIN