Provider Demographics
NPI:1689396848
Name:BILTMORE ORTHOPEDIC ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:BILTMORE ORTHOPEDIC ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAYCEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-952-8111
Mailing Address - Street 1:5080 N 40TH ST STE 103
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-2158
Mailing Address - Country:US
Mailing Address - Phone:602-952-8111
Mailing Address - Fax:602-952-1572
Practice Address - Street 1:5080 N 40TH ST STE 103
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-2158
Practice Address - Country:US
Practice Address - Phone:602-952-8111
Practice Address - Fax:602-952-1572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-14
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic TraumaGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ52958OtherAZ MEDICAL BOARD