Provider Demographics
NPI:1316973886
Name:DELAWARE ORTHOPEDICS & SPORTS MEDICINE INC
Entity type:Organization
Organization Name:DELAWARE ORTHOPEDICS & SPORTS MEDICINE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:W
Authorized Official - Last Name:MCGRAIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:740-369-8751
Mailing Address - Street 1:460 W. CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015
Mailing Address - Country:US
Mailing Address - Phone:740-369-8751
Mailing Address - Fax:740-363-7265
Practice Address - Street 1:460 W. CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015
Practice Address - Country:US
Practice Address - Phone:740-369-8751
Practice Address - Fax:740-363-7265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0872640Medicaid
OH0872640Medicaid