Healthcare Provider Details

I. General information

NPI: 1003888124
Provider Name (Legal Business Name): ARIZONA ORTHOPAEDIC SPECIALISTS LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1616 E MARYLAND AVE
PHOENIX AZ
85016-1302
US

IV. Provider business mailing address

1616 E MARYLAND AVE
PHOENIX AZ
85016-1302
US

V. Phone/Fax

Practice location:
  • Phone: 602-870-3355
  • Fax: 602-870-3044
Mailing address:
  • Phone: 602-870-3355
  • Fax: 602-870-3044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number17314
License Number StateAZ

VIII. Authorized Official

Name: RONALD MARVIN LAMPERT
Title or Position: PRESIDENT
Credential: MD
Phone: 602-870-5355