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General NPI Number Information
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NPI Number | 1376341800
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Entity Type | Organization
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Legal Business Name | ORTHOPEDIC SPECIALISTS OF NORTH AMERICA, PLLC
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Dates
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Enumeration Date | 03/03/2025
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Last Update Date | 03/03/2025
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Provider Practice Location Address
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Address Line | 21250 W ROOSEVELT ST SUITE 106
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City | BUCKEYE
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State | AZ
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Zip | 85326
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Country | US
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Telephone | 602-684-5444
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Fax | 602-772-3801
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Provider Business Mailing Address
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Address Line | PO BOX 80217
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City | PHOENIX
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State | AZ
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Zip | 85060-0217
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Country | US
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Telephone | 602-385-2115
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Fax | 480-418-3323
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Authorized Official
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Title or Position | MANAGER
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Name | DAVID OTT
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Credential | MD
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Telephone | 602-385-2115
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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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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