Healthcare Provider Details

I. General information

NPI: 1508535733
Provider Name (Legal Business Name): PRECISION HAND AND ORTHOPEDIC SURGERY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2021
Last Update Date: 04/21/2022
Certification Date: 04/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13090 N 94TH DR STE 204
PEORIA AZ
85381-4258
US

IV. Provider business mailing address

13090 N 94TH DR STE 204
PEORIA AZ
85381-4258
US

V. Phone/Fax

Practice location:
  • Phone: 623-264-3300
  • Fax: 833-913-2307
Mailing address:
  • Phone: 623-264-3300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: TANAY JAGDISH AMIN
Title or Position: PRESIDENT
Credential: MD
Phone: 623-264-3300