Provider Demographics
NPI:1669639613
Name:FERRY, AMON THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:AMON
Middle Name:THOMAS
Last Name:FERRY
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 1:8630 E VIA DE VENTURA STE 201
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-3358
Mailing Address - Country:US
Mailing Address - Phone:480-558-3744
Mailing Address - Fax:480-558-3801
Practice Address - Street 1:8630 E VIA DE VENTURA STE 201
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258
Practice Address - Country:US
Practice Address - Phone:480-558-3744
Practice Address - Fax:480-558-3801
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125047485207X00000X
AZ42706207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ86-0783428OtherTAX-ID
AZ526545Medicaid
AZ526545Medicaid