Provider Demographics
NPI:1558471052
Name:VANDERHOOF, JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:VANDERHOOF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3135 E LINCOLN DR STE B
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-2301
Mailing Address - Country:US
Mailing Address - Phone:480-800-8642
Mailing Address - Fax:602-900-9957
Practice Address - Street 1:3135 E LINCOLN DR STE B
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-2301
Practice Address - Country:US
Practice Address - Phone:480-800-8642
Practice Address - Fax:602-900-9957
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ31892207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZH94696Medicare UPIN