Healthcare Provider Details

I. General information

NPI: 1770767022
Provider Name (Legal Business Name): YAVAPAI ORTHOPAEDICS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2007
Last Update Date: 07/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 GAIL GARDNER WAY STE 100
PRESCOTT AZ
86305-1631
US

IV. Provider business mailing address

1050 GAIL GARDNER WAY STE 100
PRESCOTT AZ
86305-1631
US

V. Phone/Fax

Practice location:
  • Phone: 928-443-9753
  • Fax: 928-443-9754
Mailing address:
  • Phone: 928-443-9753
  • Fax: 928-443-9754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number4007
License Number StateAZ

VIII. Authorized Official

Name: DR. FRANCISCO JAUME
Title or Position: ORTHOPAEDIC SURGEON
Credential: D.O.
Phone: 928-443-9753