Healthcare Provider Details

I. General information

NPI: 1811002017
Provider Name (Legal Business Name): MICHAEL ADAM SOCHACKI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 01/23/2020
Certification Date: 01/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W THOMAS ROAD, SUITE 850
PHOENIX AZ
85013
US

IV. Provider business mailing address

500 W. THOMAS ROAD, SUITE 850
PHOENIX AZ
85013
US

V. Phone/Fax

Practice location:
  • Phone: 602-406-2669
  • Fax: 602-405-6889
Mailing address:
  • Phone: 602-406-2805
  • Fax: 602-212-4788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number28537
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: