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General NPI Number Information
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NPI Number | 1467986984
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Entity Type | Organization
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Legal Business Name | ORTHOPEDIC EMERGENCY SERVICES, LLC
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Dates
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Enumeration Date | 04/12/2017
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Last Update Date | 04/12/2017
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Provider Practice Location Address
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Address Line | 726 N GREENFIELD RD SUITE 108
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City | GILBERT
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State | AZ
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Zip | 85234-5061
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Country | US
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Telephone | 480-993-4618
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Fax |
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Provider Business Mailing Address
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Address Line | 726 N GREENFIELD RD SUITE 108
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City | GILBERT
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State | AZ
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Zip | 85234-5061
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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
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Name | SCOTT J ELLIS
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Credential | MD
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Telephone | 480-993-4618
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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 | 27064
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License Number State | AZ
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