Provider Demographics
NPI:1013107713
Name:SAGUARO ORTHOPEDIC ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:SAGUARO ORTHOPEDIC ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:REX
Authorized Official - Middle Name:D
Authorized Official - Last Name:COOLEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:DO
Authorized Official - Phone:520-229-9600
Mailing Address - Street 1:1871 W ORANGE GROVE RD
Mailing Address - Street 2:SUITE 135
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-1288
Mailing Address - Country:US
Mailing Address - Phone:520-229-9600
Mailing Address - Fax:520-229-9601
Practice Address - Street 1:1871 W ORANGE GROVE RD
Practice Address - Street 2:SUITE 135
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-1288
Practice Address - Country:US
Practice Address - Phone:520-229-9600
Practice Address - Fax:520-229-9601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-28
Last Update Date:2007-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ79496Medicare PIN