Healthcare Provider Details

I. General information

NPI: 1932450426
Provider Name (Legal Business Name): RONALD JOSEPH ORDAS ANP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2012
Last Update Date: 12/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10117 N 92ND ST SUITE 103
SCOTTSDALE AZ
85258-4555
US

IV. Provider business mailing address

10117 N 92ND ST SUITE 103
SCOTTSDALE AZ
85258-4555
US

V. Phone/Fax

Practice location:
  • Phone: 480-747-6532
  • Fax:
Mailing address:
  • Phone: 480-747-6532
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP4727
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: