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NPI 1053383968

NPI 1053383968 : JOEL ROHRBOUGH MD : FLAGSTAFF, AZ

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General NPI Number Information
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    NPI Number           |    1053383968
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    Entity Type          |    Individual 
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    Provider Name        |    JOEL ROHRBOUGH MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    02/03/2006
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    Last Update Date     |    03/02/2010
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Provider Practice Location Address
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    Address Line         |    1485 N TURQUOISE DR SUITE 200
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    City                 |    FLAGSTAFF
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    State                |    AZ
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    Zip                  |    86001-1398
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    Country              |    US
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    Telephone            |    928-774-7757
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    Fax                  |    928-774-7767
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Provider Business Mailing Address
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    Address Line         |    1615 N KITTREDGE RD 
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    City                 |    FLAGSTAFF
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    State                |    AZ
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    Zip                  |    86001-1176
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    Country              |    US
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    Telephone            |    928-774-7757
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    174400000X
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    Taxonomy Name        |    Specialist
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    License Number       |    29359
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    License Number State |    AZ
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Taxonomy #2
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    Taxonomy Code        |    207X00000X
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    Taxonomy Name        |    Orthopaedic Surgery Physician
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    License Number       |    29359
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    License Number State |    AZ
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Taxonomy #3
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    Taxonomy Code        |    207XX0005X
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    Taxonomy Name        |    Sports Medicine (Orthopaedic Surgery) Physician
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    License Number       |    29359
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    License Number State |    AZ
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