Provider Demographics
NPI:1548404569
Name:WILLIAM M MESZAROS MD PC
Entity Type:Organization
Organization Name:WILLIAM M MESZAROS MD PC
Other - Org Name:ARIZONA PERFORMANCE SPORTS MEDICINE AND ORTHOPAEDICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:M
Authorized Official - Last Name:MESZAROS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-553-7993
Mailing Address - Street 1:5150 N 16TH ST
Mailing Address - Street 2:STE B232
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-3925
Mailing Address - Country:US
Mailing Address - Phone:480-553-7993
Mailing Address - Fax:480-553-7995
Practice Address - Street 1:875 N GREENFIELD RD
Practice Address - Street 2:STE 108
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-5044
Practice Address - Country:US
Practice Address - Phone:480-553-7993
Practice Address - Fax:480-553-7995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-21
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ40346207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ424406Medicaid
AZZ131228Medicare PIN
AZ424406Medicaid
AZ6342020001Medicare NSC