| Organization Name: | CARONDELET MEDICAL GROUP, INC |
| NPI Number: | 1215974951 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DEB S MOHESKY (EVP/CFO) |
| Mailing Address: | 1209 W. Target Range Rd. Nogales |
| State: | AZ US |
| Postal Code: | 85621 |
| Phone Number: | 5202874747 |
| Fax Number: | 5202853135 |
| NPI Enumeration Date: | 06/01/2006 |
| NPI Last Update Date: | 02/22/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0131X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot Surgery |
| Taxonomy Definition: | |