| NPI | 1073069043 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA VAUGHT CEO 302-655-9494 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 208VP0014X Pain Medicine Interventional Pain Medicine |
| 207LP2900X Anesthesiology Pain Medicine | |
| 207QS0010X Family Medicine Sports Medicine | |
| 2081P2900X Physical Medicine & Rehabilitation Pain Medicine | |
| Enumeration Date | 2016-08-30 |
| Last Update Date | 2024-08-30 |