Provider Demographics
NPI:1952357022
Name:SONORAN ORTHOPAEDIC TRAUMA SURGEONS
Entity Type:Organization
Organization Name:SONORAN ORTHOPAEDIC TRAUMA SURGEONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:S
Authorized Official - Last Name:RHORER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-874-2040
Mailing Address - Street 1:3126 N CIVIC CENTER PLZ
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6912
Mailing Address - Country:US
Mailing Address - Phone:480-874-2040
Mailing Address - Fax:480-874-2041
Practice Address - Street 1:3126 N CIVIC CENTER PLZ
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6912
Practice Address - Country:US
Practice Address - Phone:480-874-2040
Practice Address - Fax:480-874-2041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic TraumaGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ433622Medicaid
AZZ104579Medicare PIN