Provider Demographics
NPI:1588997258
Name:PENNSYLVANIA ORTHOPAEDIC ASSOCIATES INC
Entity type:Organization
Organization Name:PENNSYLVANIA ORTHOPAEDIC ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:SUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-947-7550
Mailing Address - Street 1:727 WELSH RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-6310
Mailing Address - Country:US
Mailing Address - Phone:215-947-7550
Mailing Address - Fax:215-947-0590
Practice Address - Street 1:727 WELSH RD
Practice Address - Street 2:SUITE 103
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-6310
Practice Address - Country:US
Practice Address - Phone:215-947-7550
Practice Address - Fax:215-947-0590
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PENNSYLVANIA ORTHOPAEDIC ASSOCIATES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-09-14
Last Update Date:2009-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0003000000OtherIBC PROVIDER NUMBE