Healthcare Provider Details

I. General information

NPI: 1851345250
Provider Name (Legal Business Name): ORTHOPAEDIC & HAND SPECIALISTS P A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 02/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2718 HENRY ST
GREENSBORO NC
27405-3633
US

IV. Provider business mailing address

2718 HENRY ST
GREENSBORO NC
27405-3633
US

V. Phone/Fax

Practice location:
  • Phone: 336-375-1007
  • Fax: 336-375-9615
Mailing address:
  • Phone: 336-375-1007
  • Fax: 336-375-9615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. PHALA JEANETTE GARRETT
Title or Position: OFFICE MANAGER
Credential:
Phone: 336-375-1007