Healthcare Provider Details

I. General information

NPI: 1063097913
Provider Name (Legal Business Name): ORTHOPEDIC SURGEONS LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2021
Last Update Date: 01/06/2022
Certification Date: 01/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 SIPE AVE FL 3
HUMMELSTOWN PA
17036-9137
US

IV. Provider business mailing address

112 SIPE AVE FL 3
HUMMELSTOWN PA
17036-9137
US

V. Phone/Fax

Practice location:
  • Phone: 717-761-5530
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: HOLLY H BROWN
Title or Position: CREDENTIALING COORDINATOR
Credential:
Phone: 717-920-1861