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General NPI Number Information
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NPI Number | 1265485924
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Entity Type | Organization
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Legal Business Name | SPINE AND ORTHOPAEDIC MEDICAL CENTER
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 06/13/2012
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Provider Practice Location Address
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Address Line | 8405 N FRESNO ST SUITE 110
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City | FRESNO
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State | CA
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Zip | 93720-1538
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Country | US
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Telephone | 559-449-7645
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Fax | 559-432-1915
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Provider Business Mailing Address
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Address Line | 8405 N FRESNO ST SUITE 110
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City | FRESNO
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State | CA
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Zip | 93720-1537
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Country | US
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Telephone | 559-449-7645
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Fax | 559-432-1915
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. PAUL JAMES NUGENT
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Credential | MD
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Telephone | 559-449-7645
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State | CA
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