Provider Demographics
NPI:1497853659
Name:CV ORTHOPAEDIC SPECIALISTS, P.C.
Entity Type:Organization
Organization Name:CV ORTHOPAEDIC SPECIALISTS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:HOOVER
Authorized Official - Last Name:JOHNSTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-252-7829
Mailing Address - Street 1:8776 E SHEA BLVD
Mailing Address - Street 2:#B3A-325
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-6629
Mailing Address - Country:US
Mailing Address - Phone:602-252-7829
Mailing Address - Fax:602-252-3846
Practice Address - Street 1:525 N 18TH ST
Practice Address - Street 2:SUITE 503
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-4102
Practice Address - Country:US
Practice Address - Phone:602-252-3829
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2009-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2929207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ222183Medicaid
AZZWCKGSMedicare ID - Type UnspecifiedMEDICARE NUMBER
AZ222183Medicaid