Provider Demographics
NPI:1669652616
Name:THE CENTER FOR ORTHOPEDIC RESEARCH AND EDUCATION
Entity Type:Organization
Organization Name:THE CENTER FOR ORTHOPEDIC RESEARCH AND EDUCATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOFSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-537-5600
Mailing Address - Street 1:14420 W MEEKER BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SUN CITY WEST
Mailing Address - State:AZ
Mailing Address - Zip Code:85375-5286
Mailing Address - Country:US
Mailing Address - Phone:623-537-5600
Mailing Address - Fax:623-537-5604
Practice Address - Street 1:19636 N 27TH AVE
Practice Address - Street 2:SUITE LL-2
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-4013
Practice Address - Country:US
Practice Address - Phone:623-537-5600
Practice Address - Fax:623-537-5601
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE CENTER FOR ORTHOPEDIC RESEARCH AND EDUCATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-11-07
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ102176Medicare PIN