Provider Demographics
NPI:1568654697
Name:DVS ORTHOPAEDICS, INC.
Entity Type:Organization
Organization Name:DVS ORTHOPAEDICS, INC.
Other - Org Name:DVS ORTHOPAEDICS, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAN
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:E
Authorized Official - Last Name:VON STEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:435-640-8775
Mailing Address - Street 1:1486 E SKYLINE DR
Mailing Address - Street 2:STE 202
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84405-4859
Mailing Address - Country:US
Mailing Address - Phone:801-475-5683
Mailing Address - Fax:
Practice Address - Street 1:1486 E SKYLINE DR
Practice Address - Street 2:STE 202
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84405-4859
Practice Address - Country:US
Practice Address - Phone:801-475-5683
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-13
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6071688-1205207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTA16465Medicare UPIN