| NPI | 1194735779 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA VAUGHT CEO 302-655-9494 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine |
| 207QS0010X Family Medicine Sports Medicine | |
| 208100000X Physical Medicine & Rehabilitation | |
| 2081P2900X Physical Medicine & Rehabilitation Pain Medicine | |
| 2086S0122X Surgery Plastic and Reconstructive Surgery | |
| 208VP0014X Pain Medicine Interventional Pain Medicine | |
| 213ES0103X Podiatrist Foot & Ankle Surgery | |
| 225X00000X Occupational Therapist | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2024-08-30 |