Healthcare Provider Details
I. General information
NPI: 1295044964
Provider Name (Legal Business Name): ORTHOPEDIC SPECIALISTS OF NORTH AMERICA, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/29/2010
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6760 W THUNDERBIRD RD STE E110
PEORIA AZ
85381-5027
US
IV. Provider business mailing address
PO BOX 80217
PHOENIX AZ
85060-0217
US
V. Phone/Fax
- Phone: 623-846-7614
- Fax:
- Phone: 602-385-2115
- Fax: 480-418-3323
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | |
| License Number State | AZ |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207XS0106X |
| Taxonomy | Orthopaedic Hand Surgery Physician |
| License Number | |
| License Number State | AZ |
VIII. Authorized Official
Name:
RAJAN
DILIP
BHATT
Title or Position: AUTHORIZED OFFICIAL
Credential: MD
Phone: 602-385-2115