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General NPI Number Information
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NPI Number | 1104550698
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Entity Type | Organization
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Legal Business Name | SCOTTSDALE HIP AND KNEE, LLC
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Dates
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Enumeration Date | 07/12/2022
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Last Update Date | 01/31/2023
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Provider Practice Location Address
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Address Line | 10290 N 92ND ST
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-4522
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Country | US
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Telephone | 480-905-2015
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Fax | 480-716-4347
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Provider Business Mailing Address
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Address Line | 8776 E SHEA BLVD STE 106
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-6687
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING
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Name | DIANE TALOSIG
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Credential |
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Telephone | 480-905-2015
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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