Provider Demographics
NPI:1053560243
Name:CENTER FOR ORTHOPEDIC RESEARCH AND EDUCATION INC
Entity type:Organization
Organization Name:CENTER FOR ORTHOPEDIC RESEARCH AND EDUCATION INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOFSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:623-537-5600
Mailing Address - Street 1:3010 W AGUA FRIA FWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-3943
Mailing Address - Country:US
Mailing Address - Phone:623-537-5600
Mailing Address - Fax:623-544-5531
Practice Address - Street 1:13555 W MCDOWELL RD
Practice Address - Street 2:SUITE 201
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395-2624
Practice Address - Country:US
Practice Address - Phone:623-537-5600
Practice Address - Fax:623-537-5601
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTER FOR ORTHOPEDIC RESEARCH AND EDUCATION INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-09-12
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ5550830008Medicare NSC
AZZ102176Medicare PIN