Provider Demographics
NPI:1841202678
Name:THE JOINT REPLACEMENT CENTER OF SCOTTSDALE
Entity Type:Organization
Organization Name:THE JOINT REPLACEMENT CENTER OF SCOTTSDALE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:THEODORE
Authorized Official - Middle Name:PHILLIP
Authorized Official - Last Name:FIRESTONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-237-5723
Mailing Address - Street 1:10250 N 92ND ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4510
Mailing Address - Country:US
Mailing Address - Phone:480-237-5727
Mailing Address - Fax:480-657-3207
Practice Address - Street 1:10250 NORTH 92ND STREET
Practice Address - Street 2:SUITE 202
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-6709
Practice Address - Country:US
Practice Address - Phone:480-237-5727
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DF2691OtherRAILROAD MEDICARE
AZ111925Medicare ID - Type Unspecified