Provider Demographics
NPI:1558930198
Name:ALPHA ORTHOPEDIC SURGICAL SERVICES LLC
Entity Type:Organization
Organization Name:ALPHA ORTHOPEDIC SURGICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:MEIER
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:218-849-4599
Mailing Address - Street 1:1776 N SCOTTSDALE RD #368
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85252-0368
Mailing Address - Country:US
Mailing Address - Phone:480-201-5264
Mailing Address - Fax:480-393-1970
Practice Address - Street 1:10401 W THUNDERBIRD BLVD
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351
Practice Address - Country:US
Practice Address - Phone:480-201-5264
Practice Address - Fax:480-393-1970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-18
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty