Healthcare Provider Details

I. General information

NPI: 1669652616
Provider Name (Legal Business Name): THE CENTER FOR ORTHOPEDIC RESEARCH AND EDUCATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2007
Last Update Date: 11/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19636 N 27TH AVE SUITE LL-2
PHOENIX AZ
85027-4013
US

IV. Provider business mailing address

14420 W MEEKER BLVD SUITE 300
SUN CITY WEST AZ
85375-5286
US

V. Phone/Fax

Practice location:
  • Phone: 623-537-5600
  • Fax: 623-537-5601
Mailing address:
  • Phone: 623-537-5600
  • Fax: 623-537-5604

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DAVID JACOFSKY
Title or Position: MD
Credential:
Phone: 623-537-5600