| NPI | 1215079678 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER L JACKSON Senior Director, Enrollment 877-892-9815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NM 77-108) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NM 2001-213) |
| 2085R0202X Radiology, Diagnostic Radiology | |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2022-01-25 |