MEDICARE: BILTMORE ORTHOPEDIC ASSOCIATES, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207XX0801X	Orthopaedic Trauma Physician
2	207X00000X	Orthopaedic Surgery Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	52958	OTHER	AZ	AZ MEDICAL BOARD

General Provider Information

NPI Number	:	1689396848
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BILTMORE ORTHOPEDIC ASSOCIATES, PLLC

Provider Business Mailing Address
First Line	:	5080 N 40TH ST STE 103
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85018-2158
Country	:	US
Telephone Number	:	602-952-8111
Fax Number	:	602-952-1572

Provider Business Practice Location Address
First Line	:	5080 N 40TH ST STE 103
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85018-2158
Country	:	US
Telephone Number	:	602-952-8111
Fax Number	:	602-952-1572

Authorized Official
Title or Position	:	PHYSICIAN OWNER
Name	:	JAYCEN C BROWN
Credential	:	MD
Telephone Number	:	602-952-8111

Provider Enumeration Date	:	09/14/2022
Last Update Date	:	09/20/2022

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