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General NPI Number Information
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NPI Number | 1497278097
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Entity Type | Organization
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Legal Business Name | GRAYHAWK ORTHOPEDIC SURGERY PLLC
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Dates
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Enumeration Date | 07/25/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 7960 E THOMPSON PEAK PKWY STE 104
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-7406
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Country | US
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Telephone | 210-322-3242
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Fax |
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Provider Business Mailing Address
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Address Line | 7960 E THOMPSON PEAK PKWY STE 104
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-7406
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Country | US
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Telephone | 210-322-3242
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JAGDEEP SINGH SODHI
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Credential | MD
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Telephone | 210-322-3242
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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 | 5390
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License Number State | AZ
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