Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 18636 | AZ |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | 18636 | AZ |
N | 207XS0106X | Orthopaedic Hand Surgeon | 18636 | AZ |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 18636 | AZ |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 18636 | AZ |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 18636 | AZ |
N | 207XX0801X | Orthopaedic Trauma Surgeon | 18636 | AZ |
NPI | 1861531089 |
---|---|
Provider Name | Dr. Joseph A Longo Iii |
First Address | Scottsdale, AZ 85251-6411 |
Second Address | Scottsdale, AZ 85251-6411 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E28379 | (02) | AZ |