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General NPI Number Information
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NPI Number | 1598829541
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Entity Type | Organization
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Legal Business Name | AZZO ORTHOPEDICS, PLLC
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Dates
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Enumeration Date | 12/21/2006
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Last Update Date | 01/04/2011
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Provider Practice Location Address
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Address Line | 512 CHERRY ST BLDG I
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City | BLUEFIELD
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State | WV
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Zip | 24701-3341
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Country | US
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Telephone | 304-324-2725
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Fax | 304-324-2780
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Provider Business Mailing Address
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Address Line | PO BOX 1696
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City | BLUEFIELD
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State | WV
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Zip | 24701-1696
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Country | US
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Telephone | 304-324-2725
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Fax | 304-324-2780
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. WALID HIKMET AZZO
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Credential | MD.PH.D.
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Telephone | 304-324-2725
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 17728
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License Number State | WV
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