Provider Demographics
NPI:1427561893
Name:ORTHOPEDIC SPECIALISTS OF NORTH AMERICA PLLC
Entity Type:Organization
Organization Name:ORTHOPEDIC SPECIALISTS OF NORTH AMERICA PLLC
Other - Org Name:ORTHOARIZONA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DALEINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BULGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-385-2115
Mailing Address - Street 1:PO BOX 271429
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-1429
Mailing Address - Country:US
Mailing Address - Phone:602-631-3161
Mailing Address - Fax:602-631-3162
Practice Address - Street 1:3033 N 44TH ST STE 100
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-7227
Practice Address - Country:US
Practice Address - Phone:602-631-3161
Practice Address - Fax:602-631-3162
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORTHOPEDIC SPECIALISTS OF NORTH AMERICA PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-11-08
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Multi-Specialty
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty