Organization
ORTHOPEDIC SPECIALISTS OF NORTH AMERICA PLLC
Active
Parent organization
ORTHOPEDIC SPECIALISTS OF NORTH AMERICA PLLC
Other names
OSNA Active Orthopedic Division
Organization subpart
Yes
Provider details
NPI number
Legal business name
ORTHOPEDIC SPECIALISTS OF NORTH AMERICA PLLC
Authorized official
DR. JOHN BRADWAY MD (CHIEF EXECUTIVE OFFICER)
(480) 860-6005
Entity
Organization
Contact information
Practice address
4566 E INVERNESS AVE, SUITE 108, MESA, AZ 85206-4633
(480) 889-3988
Mailing address
PO BOX 271429, SALT LAKE CITY, UT 84127-1429
(602) 772-3800
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XS0106X
Orthopaedic Hand Surgery Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DQ4501
RAILROAD MEDICARE PTAN
AZ
Enumeration date
03/03/2010
Last updated
11/09/2016
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