Provider Demographics
NPI:1407584907
Name:ARIZONA ORTHOPEDIC & SPINE INSTITUTE
Entity Type:Organization
Organization Name:ARIZONA ORTHOPEDIC & SPINE INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROSS
Authorized Official - Middle Name:
Authorized Official - Last Name:SHERBAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:248-217-6701
Mailing Address - Street 1:3133 E LINCOLN DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-2317
Mailing Address - Country:US
Mailing Address - Phone:480-617-8089
Mailing Address - Fax:480-452-0777
Practice Address - Street 1:3133 E LINCOLN DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-2317
Practice Address - Country:US
Practice Address - Phone:480-617-8089
Practice Address - Fax:480-452-0777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty