Provider Demographics
NPI:1760402952
Name:SOUTHWEST ORTHOPAEDIC SURGERY SPECIALISTS, PLC
Entity Type:Organization
Organization Name:SOUTHWEST ORTHOPAEDIC SURGERY SPECIALISTS, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ARIO
Authorized Official - Middle Name:B
Authorized Official - Last Name:KIARASH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-327-9677
Mailing Address - Street 1:7520 N ORACLE RD STE 200
Mailing Address - Street 2:SUITE 200
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-4449
Mailing Address - Country:US
Mailing Address - Phone:520-327-9677
Mailing Address - Fax:520-327-9678
Practice Address - Street 1:7520 N ORACLE RD STE 200
Practice Address - Street 2:SUITE 200
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-4449
Practice Address - Country:US
Practice Address - Phone:520-327-9677
Practice Address - Fax:520-327-9678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
5606420001Medicare NSC
AZZ105912Medicare PIN