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Physicians Orthopaedic Surgery

Provider NPI: 1427404672

Provider Information:
Gender: M
Sole Proprietor

Practice Location:
80 RAVEN LANE  DEPOE BAY, OR 97341-0185 US
Tel: 541-764-2113  Fax: --

Business Mailing Address:
PO BOX 185  DEPOE BAY, OR 97341-0185 US
Tel: 541-764-2113  Fax: --

NPI Information:
NPI: 1427404672
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Orthopaedic Surgery
Orthopaedic Surgery

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 207X00000X





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