Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 24072 | AZ |
NPI | 1003810052 |
---|---|
Provider Name | Mr. Anthony C Theiler |
First Address | Scottsdale, AZ 85258-4510 |
Second Address | Scottsdale, AZ 85258-4510 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2005 |
Last Update Date | 30/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G13651 | (02) |