Provider Demographics
NPI:1962593756
Name:DESERT BONE & JOINT SURGEONS, LTD.
Entity type:Organization
Organization Name:DESERT BONE & JOINT SURGEONS, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:MOTZKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-969-7444
Mailing Address - Street 1:2175 N ALMA SCHOOL RD
Mailing Address - Street 2:A104
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-2878
Mailing Address - Country:US
Mailing Address - Phone:480-969-7444
Mailing Address - Fax:480-969-1870
Practice Address - Street 1:2175 N ALMA SCHOOL RD
Practice Address - Street 2:A104
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-2878
Practice Address - Country:US
Practice Address - Phone:480-969-7444
Practice Address - Fax:480-969-1870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ15046,22845,23800174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ193574Medicaid
AZ472085Medicaid
AZ26460601Medicaid
AZ20WCHFM01Medicare PIN
AZ472085Medicaid