Provider Demographics
NPI:1790813988
Name:ORTHOPAEDIC SURGICAL ASSOCIATES
Entity Type:Organization
Organization Name:ORTHOPAEDIC SURGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:A
Authorized Official - Last Name:EVANKOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-226-1199
Mailing Address - Street 1:1624 PACIFIC AVE
Mailing Address - Street 2:STE. A
Mailing Address - City:NATRONA HEIGHTS
Mailing Address - State:PA
Mailing Address - Zip Code:15065-2101
Mailing Address - Country:US
Mailing Address - Phone:724-226-1199
Mailing Address - Fax:724-226-1479
Practice Address - Street 1:107 GAMMA DR
Practice Address - Street 2:STE. 120
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-2982
Practice Address - Country:US
Practice Address - Phone:412-784-1333
Practice Address - Fax:412-784-9220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty