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>> Orthopaedic Surgery >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1578772331

Individual Registrant:
Gender: M
Not Sole Proprietor

Location and contact information for practice:
1505 DAPHNE AVE  DAPHNE, AL 36526-4298 US
Tel: (25-1) -625-2663  Fax: 251-625-3198

Contact information for business:
1505 DAPHNE AVE  DAPHNE, AL 36526-4298 US
Tel: (25-1) -625-2663  Fax: 251-625-3198

Registration Information:
NPI: 1578772331
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N207X00000XAllopathic & Osteopathic Physicians
Orthopaedic Surgery
Y207X00000XAllopathic & Osteopathic Physicians
Orthopaedic Surgery

Legacy codes, insurance codes and state license numbers:



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