| NPI | 1598153603 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANTE L JACKSON Enrollment 215-662-6187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine |
| 207XS0106X Orthopaedic Surgery, Hand Surgery | |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine | |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma | |
| 208100000X Physical Medicine & Rehabilitation | |
| 208200000X Plastic Surgery | |
| Enumeration Date | 2014-12-26 |
| Last Update Date | 2020-11-19 |