Healthcare Provider Details

I. General information

NPI: 1043272628
Provider Name (Legal Business Name): JOHN C OPIE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2006
Last Update Date: 11/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8575 E PRINCESS DR SUITE 117
SCOTTSDALE AZ
85255-5483
US

IV. Provider business mailing address

8575 E PRINCESS DR SUITE 117
SCOTTSDALE AZ
85255-5483
US

V. Phone/Fax

Practice location:
  • Phone: 480-889-1961
  • Fax: 480-264-7012
Mailing address:
  • Phone: 480-889-1961
  • Fax: 480-264-7012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number19784
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: