Healthcare Provider Details

I. General information

NPI: 1255499091
Provider Name (Legal Business Name): PHOENIX ORTHOPAEDIC CONSULTANTS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 04/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19636 N 27TH AVE SUITE 401
PHOENIX AZ
85027-4013
US

IV. Provider business mailing address

19636 N 27TH AVE SUITE 401
PHOENIX AZ
85027-4013
US

V. Phone/Fax

Practice location:
  • Phone: 602-298-8888
  • Fax: 623-516-4735
Mailing address:
  • Phone: 602-298-8888
  • Fax: 623-516-4735

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: STEPHEN RIPPLE
Title or Position: MANAGING PARTNER
Credential: M.D.
Phone: 602-298-8888