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General NPI Number Information
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NPI Number | 1457808495
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Entity Type | Organization
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Legal Business Name | SHRINERS HOSPITALS FOR CHILDREN
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Dates
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Enumeration Date | 09/07/2016
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Last Update Date | 10/04/2017
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Provider Practice Location Address
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Address Line | 110 CONN TER
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City | LEXINGTON
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State | KY
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Zip | 40508-3206
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Country | US
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Telephone | 859-266-2101
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8500 LOCKBOX #7642
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City | PHILADELPHIA
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State | PA
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Zip | 19178-7642
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ANTHONY LEWGOOD
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Credential |
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Telephone | 959-268-5631
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207XP3100X
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Taxonomy Name | Pediatric Orthopaedic Surgery Physician
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License Number |
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License Number State |
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