Provider Demographics
NPI:1497278097
Name:GRAYHAWK ORTHOPEDIC SURGERY PLLC
Entity Type:Organization
Organization Name:GRAYHAWK ORTHOPEDIC SURGERY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAGDEEP
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:SODHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-322-3242
Mailing Address - Street 1:7960 E THOMPSON PEAK PKWY STE 104
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-7406
Mailing Address - Country:US
Mailing Address - Phone:210-322-3242
Mailing Address - Fax:
Practice Address - Street 1:7960 E THOMPSON PEAK PKWY STE 104
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-7406
Practice Address - Country:US
Practice Address - Phone:210-322-3242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5390207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty