Provider Demographics
NPI:1396923025
Name:TOTAL ORTHOPEDICS, LLC
Entity type:Organization
Organization Name:TOTAL ORTHOPEDICS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OPERATIONS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-818-0446
Mailing Address - Street 1:14010 N NORTHSIGHT BLVD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-3601
Mailing Address - Country:US
Mailing Address - Phone:480-443-0384
Mailing Address - Fax:480-443-0389
Practice Address - Street 1:14010 N NORTHSIGHT BLVD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-3601
Practice Address - Country:US
Practice Address - Phone:480-443-0384
Practice Address - Fax:480-443-0389
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOTAL ORTHOPEDICS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-05
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN44D1072470291U00000X
174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No291U00000XLaboratoriesClinical Medical LaboratoryGroup - Single Specialty