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Organization

DISTRICT MEDICAL GROUP, INC

Active
Parent organization
DISTRICT MEDICAL GROUP INC
Organization subpart
Yes

Provider details

NPI number
Legal business name
DISTRICT MEDICAL GROUP INC
Authorized official
TERESA CORDEIRO (CREDENTIALING DIRECTOR)
(602) 470-5000
Entity
Organization

Contact information

Practice address
2525 E ROOSEVELT ST, ORTHOPEDIC CLINIC, PHOENIX, AZ 85008-4948
(602) 344-5895
Mailing address
2929 E THOMAS RD, PHOENIX, AZ 85016-8034
(602) 470-5000

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
207XP3100X
Pediatric Orthopaedic Surgery Physician
207XS0106X
Orthopaedic Hand Surgery Physician
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
207XX0801X
Orthopaedic Trauma Physician

Other

Enumeration date
09/09/2009
Last updated
10/01/2014
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