Healthcare Provider Details

I. General information

NPI: 1851530471
Provider Name (Legal Business Name): PHOENIX ORTHOPEDICS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2009
Last Update Date: 01/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9377 E BELL RD SUITE 207
SCOTTSDALE AZ
85260-1502
US

IV. Provider business mailing address

PO BOX 925185
HOUSTON TX
77292-5185
US

V. Phone/Fax

Practice location:
  • Phone: 480-473-1901
  • Fax: 480-567-0292
Mailing address:
  • Phone: 713-586-6705
  • Fax:

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: RALPH NORMAN PURCELL
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 480-473-1901