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Organization

GREGORY T EVANGELISTA MD LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GREGORY T EVANGELISTA M.D. (PHYSICIAN OWNER)
(480) 254-8482
Entity
Organization

Contact information

Practice address
3271 N CIVIC CENTER PLZ STE 110, SCOTTSDALE, AZ 85251-6990
(480) 656-0291
(480) 656-0127
Mailing address
PO BOX 5495, SCOTTSDALE, AZ 85261-5495
(480) 656-0291
(480) 656-0127

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
207XX0801X
Orthopaedic Trauma Physician

Other

Enumeration date
05/02/2014
Last updated
09/02/2019
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