Healthcare Provider Details

I. General information

NPI: 1043276884
Provider Name (Legal Business Name): ORTHOPAEDIC SOLUTIONS AND SPORTS MEDICINE CENTER PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2006
Last Update Date: 05/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

721 TILGHMAN DR SUITE 100
DUNN NC
28334-6063
US

IV. Provider business mailing address

721 TILGHMAN DR SUITE 100
DUNN NC
28334-6063
US

V. Phone/Fax

Practice location:
  • Phone: 910-891-4202
  • Fax: 910-891-2602
Mailing address:
  • Phone: 910-891-4202
  • Fax: 910-891-2602

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number9501044
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number9501044
License Number StateNC

VIII. Authorized Official

Name: DR. JAYLAN R PARIKH
Title or Position: OWNER
Credential: MD
Phone: 910-891-4202