Provider Demographics
NPI:1558384958
Name:ARIZONA BONE & JOINT SPECIALISTS, LTD
Entity Type:Organization
Organization Name:ARIZONA BONE & JOINT SPECIALISTS, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER/MD
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:C
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-493-9361
Mailing Address - Street 1:5620 E BELL RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-5950
Mailing Address - Country:US
Mailing Address - Phone:602-493-9361
Mailing Address - Fax:602-493-9508
Practice Address - Street 1:5620 E BELL RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-5950
Practice Address - Country:US
Practice Address - Phone:602-493-9361
Practice Address - Fax:602-493-9508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2010-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ=========OtherTAX ID
AZ0724650001Medicare NSC
ZWCHTXMedicare PIN
AZCS5669Medicare PIN