Provider Demographics
NPI:1427290600
Name:LEHIGH VALLEY BONE MUSCLE AND JOINT
Entity type:Organization
Organization Name:LEHIGH VALLEY BONE MUSCLE AND JOINT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-691-0973
Mailing Address - Street 1:2111 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18042-3803
Mailing Address - Country:US
Mailing Address - Phone:610-253-9617
Mailing Address - Fax:610-253-6705
Practice Address - Street 1:2111 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042-3803
Practice Address - Country:US
Practice Address - Phone:610-253-9617
Practice Address - Fax:610-253-6705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-02
Last Update Date:2009-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD020512E207X00000X
PAMD025852E207X00000X
PAMD020418E207X00000X
PAMD068025L207X00000X
PAMD045442E207X00000X
PAMD073243L207XX0004X
PASC005889213E00000X
PAPT015128225100000X
PAPT017225225100000X
PAPT01170L225100000X
332B00000X
PAMA000260L363AS0400X
PAMA000849L363AS0400X
PAMA052482363AS0400X
PAMA051246363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle SurgeryGroup - Multi-Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016257690018Medicaid
PA0016257690018Medicaid
PAB34009Medicare UPIN
PAV07775Medicare UPIN
PAI10388Medicare UPIN
PA4324850003Medicare NSC
PAC33728Medicare UPIN
PAE33566Medicare UPIN
PAI29781Medicare UPIN
PAH19758Medicare UPIN
PA868033Medicare PIN