MEDICARE: INTEGRATED ORTHOPEDICS SURGICAL SERVICES

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	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1154917789
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRATED ORTHOPEDICS SURGICAL SERVICES

Provider Business Mailing Address
First Line	:	18291 N. PIMA RD. #110
Second Line	:	BOX 352
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85255
Country	:	US
Telephone Number	:	602-734-1828
Fax Number	:

Provider Business Practice Location Address
First Line	:	13215 N 7TH ST STE 100
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85022-5300
Country	:	US
Telephone Number	:	602-734-1828
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF NURSING
Name	:	TINA MEYERS
Credential	:	MSN, RN, CNOR
Telephone Number	:	602-734-1828

Provider Enumeration Date	:	12/17/2020
Last Update Date	:	12/17/2020

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