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General NPI Number Information
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NPI Number | 1417189408
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE ORTHOPEDICS, LLC
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Dates
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Enumeration Date | 08/10/2009
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Last Update Date | 08/10/2009
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Provider Practice Location Address
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Address Line | 10595 N. TATUM BLVD., SUITE E 142
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City | PARADISE VALLEY
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State | AZ
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Zip | 85253
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Country | US
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Telephone | 602-570-8628
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 55877
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City | PHOENIX
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State | AZ
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Zip | 85078-5877
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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 | PRESIDENT - MANAGER
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Name | DR. HANY E. HANNALLAH
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Credential | M.D., M.B.A.
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Telephone | 602-570-8628
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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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