MEDICARE: JOHN C OPIE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	19784	AZ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	Z125741	OTHER	AZ	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AZ0351090	OTHER	AZ	BCBS

General Provider Information

NPI Number	:	1043272628
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN C OPIE MD

Provider Business Mailing Address
First Line	:	8575 E PRINCESS DR
Second Line	:	SUITE 117
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85255-5483
Country	:	US
Telephone Number	:	480-889-1961
Fax Number	:	480-264-7012

Provider Business Practice Location Address
First Line	:	8575 E PRINCESS DR
Second Line	:	SUITE 117
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85255-5483
Country	:	US
Telephone Number	:	480-889-1961
Fax Number	:	480-264-7012

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2006
Last Update Date	:	11/14/2012

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Directions to “ JOHN C OPIE MD” Practice Location

Language	Start Address	Practice Location

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