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General NPI Number Information
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NPI Number | 1467635532
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Entity Type | Organization
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Legal Business Name | PROGRESSIVE ORTHOPAEDICS, INC
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Dates
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Enumeration Date | 12/12/2007
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Last Update Date | 02/19/2009
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Provider Practice Location Address
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Address Line | 150 SPRINGSIDE DR SUITE C320
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City | AKRON
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State | OH
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Zip | 44333-2468
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Country | US
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Telephone | 330-670-8020
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Fax | 330-670-8045
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Provider Business Mailing Address
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Address Line | 150 SPRINGSIDE DR SUITE C320
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City | AKRON
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State | OH
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Zip | 44333-2468
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Country | US
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Telephone | 330-670-8020
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Fax | 330-670-8045
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Authorized Official
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Title or Position | PRESIDENT/PROGRESSIVE ORTHOPAEDICS,
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Name | DR. PHILIP GARY WILCOX
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Credential | M.D.
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Telephone | 330-670-8020
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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 | 35045740
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License Number State | OH
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