Organization
ARIZONA DESERT ORTHOPAEDIC CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS D. HAMM (PRESIDENT)
(623) 974-6542
Entity
Organization
Contact information
Practice address
13660 N 94TH DR, SUITE C1, PEORIA, AZ 85381-4836
(623) 974-6542
(623) 321-1215
Mailing address
13660 N 94TH DR, SUITE C1, PEORIA, AZ 85381-4836
(623) 974-6542
(623) 321-1215
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
CPO 0057
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1649339615
BLUE CROSS & BLUE SHIELD OF ARIZONA
AZ
01
—
1Z7000
HEALTHNET
AZ
01
—
3231829
CIGNA
AZ
Enumeration date
12/06/2006
Last updated
05/15/2013
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