Provider Demographics
NPI:1497874317
Name:JONATHAN C WEINRACH MD PLLC
Entity Type:Organization
Organization Name:JONATHAN C WEINRACH MD PLLC
Other - Org Name:TRAUMA RECONSTRUCTION SURGERY OF ARIZONA
Other - Org Type:Other Name
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:WEINRACH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-634-6014
Mailing Address - Street 1:10229 N 92ND ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4562
Mailing Address - Country:US
Mailing Address - Phone:480-634-6014
Mailing Address - Fax:480-393-7246
Practice Address - Street 1:10229 N 92ND ST
Practice Address - Street 2:SUITE 102
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4562
Practice Address - Country:US
Practice Address - Phone:480-634-6014
Practice Address - Fax:480-393-7246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ329582086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZH93156Medicare UPIN
AZ109396Medicare PIN