Provider Demographics
NPI:1902358203
Name:GS ORTHOPEDIC SERVICES LLC
Entity Type:Organization
Organization Name:GS ORTHOPEDIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:GREGORY
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-899-4333
Mailing Address - Street 1:3530 S VAL VISTA DR
Mailing Address - Street 2:SUITE B105
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-7318
Mailing Address - Country:US
Mailing Address - Phone:480-899-4333
Mailing Address - Fax:480-899-7219
Practice Address - Street 1:3530 S VAL VISTA DR
Practice Address - Street 2:SUITE B105
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-7318
Practice Address - Country:US
Practice Address - Phone:480-899-4333
Practice Address - Fax:480-899-7219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-03
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ36729207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty