MEDICARE: ORTHOPEDIC SPECIALISTS OF NORTH AMERICA, PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207XS0106X	Orthopaedic Hand Surgery Physician
2	208100000X	Physical Medicine & Rehabilitation Physician
3	207X00000X	Orthopaedic Surgery Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DQ4501	OTHER	AZ	RAILROAD MEDICARE

General Provider Information

NPI Number	:	1780906693
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORTHOPEDIC SPECIALISTS OF NORTH AMERICA, PLLC

Provider Business Mailing Address
First Line	:	PO BOX 29870
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85038-9870
Country	:	US
Telephone Number	:	602-772-3800
Fax Number	:

Provider Business Practice Location Address
First Line	:	4852 E BASELINE RD
Second Line	:	SUITE C-107
City	:	MESA
State	:	AZ
Zip	:	85206-4627
Country	:	US
Telephone Number	:	480-834-7000
Fax Number	:	480-834-7002

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	DR. PAUL BARNES
Credential	:	PH.D
Telephone Number	:	602-772-3800

Provider Enumeration Date	:	02/18/2010
Last Update Date	:	12/11/2013

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