Organization
MOHAVE DESERT ORTHOPAEDIC CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EMMETT TERRANCE MCELENEY M.D. (MANAGER)
(928) 681-8681
Entity
Organization
Contact information
Practice address
1739 E BEVERLY AVE, SUITE 101, KINGMAN, AZ 86409-3593
(928) 681-8681
(928) 681-8682
Mailing address
1739 E BEVERLY AVE, SUITE 101, KINGMAN, AZ 86409-3593
(928) 681-8681
(928) 681-8682
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07-4761
CITY LICENSE
AZ
Enumeration date
01/31/2007
Last updated
02/29/2008
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