Provider Demographics
NPI:1699739805
Name:ORTHOPAEDIC SURGEONS INC
Entity type:Organization
Organization Name:ORTHOPAEDIC SURGEONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:E
Authorized Official - Last Name:STEPHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-454-2401
Mailing Address - Street 1:204 WEST 26 STREET
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16508-1898
Mailing Address - Country:US
Mailing Address - Phone:814-454-2401
Mailing Address - Fax:814-459-5992
Practice Address - Street 1:204 WEST 26 STREET
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16508-1898
Practice Address - Country:US
Practice Address - Phone:814-454-2401
Practice Address - Fax:814-459-5992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-14
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA119770100OtherUS DEPT OF LABOR
PA1453653OtherHIGHMARK PT
PA008032OtherHIGHMARK OFC
CF2245OtherRR MEDICARE
PA0007283130005Medicaid
PA119770100OtherUS DEPT OF LABOR
PA0007283130005Medicaid