Provider Demographics
NPI:1124140488
Name:PHILIP J ORGAN DPM PA
Entity type:Organization
Organization Name:PHILIP J ORGAN DPM PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:ORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:239-434-0484
Mailing Address - Street 1:12958 BRYNWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34105-4804
Mailing Address - Country:US
Mailing Address - Phone:239-434-0484
Mailing Address - Fax:239-434-0485
Practice Address - Street 1:12958 BRYNWOOD WAY
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34105-4804
Practice Address - Country:US
Practice Address - Phone:239-434-0484
Practice Address - Fax:239-434-0485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK6597Medicare ID - Type Unspecified