Healthcare Provider Details

I. General information

NPI: 1710016894
Provider Name (Legal Business Name): AMARILLO BONE & JOINT CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 04/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 S SONCY RD STE 129
AMARILLO TX
79119-6406
US

IV. Provider business mailing address

3501 S SONCY RD STE 129
AMARILLO TX
79119-6406
US

V. Phone/Fax

Practice location:
  • Phone: 806-468-9700
  • Fax: 806-468-9771
Mailing address:
  • Phone: 806-468-9700
  • Fax: 806-468-9771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberH7902
License Number StateTX

VIII. Authorized Official

Name: DR. KEITH D BJORK
Title or Position: OWNER
Credential: M.D.
Phone: 806-468-9700