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General NPI Number Information
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NPI Number | 1326900093
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Entity Type | Organization
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Legal Business Name | AZ ORTHOPEDICS LLC
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Dates
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Enumeration Date | 12/01/2025
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 13660 N 94TH DR STE C4
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City | PEORIA
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State | AZ
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Zip | 85381-4841
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Country | US
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Telephone | 480-697-4824
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 33727
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City | BELFAST
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State | ME
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Zip | 04915-0615
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Country | US
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Telephone | 480-697-4824
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Fax |
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Authorized Official
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Title or Position | OWNER MD
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Name | TIMOTHY SEAN KAVANAUGH
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Credential |
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Telephone | 907-351-7502
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #3
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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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