Healthcare Provider Details

I. General information

NPI: 1629076609
Provider Name (Legal Business Name): PHOENIXVILLE ORTHOPEDIC ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2005
Last Update Date: 01/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 MAIN ST
PHOENIXVILLE PA
19460-3810
US

IV. Provider business mailing address

400 MAIN ST
PHOENIXVILLE PA
19460-3810
US

V. Phone/Fax

Practice location:
  • Phone: 610-935-5507
  • Fax:
Mailing address:
  • Phone: 610-935-5507
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberNONE
License Number StatePA

VIII. Authorized Official

Name: JOHN JOSEPH PELL
Title or Position: PRESIDENT
Credential: MD
Phone: 610-935-1120