Provider Demographics
NPI:1174014864
Name:PHOENIX ORTHOPAEDIC CONSULTANTS, P.C.
Entity Type:Organization
Organization Name:PHOENIX ORTHOPAEDIC CONSULTANTS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-424-1886
Mailing Address - Street 1:19636 N 27TH AVE STE 401
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-4021
Mailing Address - Country:US
Mailing Address - Phone:602-424-1886
Mailing Address - Fax:
Practice Address - Street 1:18699 N 67TH AVE STE 120
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-7141
Practice Address - Country:US
Practice Address - Phone:602-298-8888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-29
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty