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Physicians Orthopaedic Surgery

Provider NPI: 1326044041

Provider Information:
Gender: M
Not Sole Proprietor

Practice Location:
701 8TH AVE NW STE A ABERDEEN, SD 57401-1803 US
Tel: 605-226-2663  Fax: 605-226-0095

Business Mailing Address:
8854 W EMERALD ST STE 140 BOISE, ID 83704-4845 US
Tel: 208-375-2782  Fax: 208-375-2782

NPI Information:
NPI: 1326044041
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Orthopaedic Surgery

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 207X00000X





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