Basic Information
| Provider Information | |||||||||
| NPI: | 1063566347 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ARIZONA INSTITUTE FOR BONE AND JOINT DISORDERS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13832 N 32ND ST | ||||||||
| Address2: | SUITE 150 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850325613 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6025533113 | ||||||||
| FaxNumber: | 6026677991 | ||||||||
| Practice Location | |||||||||
| Address1: | 2122 E HIGHLAND AVE | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850164739 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6025533113 | ||||||||
| FaxNumber: | 6026677991 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/23/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | HEDLEY | ||||||||
| AuthorizedOfficialFirstName: | ANTHONY | ||||||||
| AuthorizedOfficialMiddleName: | KEITH | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6025533113 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M. D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.