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General NPI Number Information
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NPI Number | 1952600934
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Entity Type | Organization
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Legal Business Name | JDI SURGICAL INC
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Dates
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Enumeration Date | 03/16/2011
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Last Update Date | 03/16/2011
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Provider Practice Location Address
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Address Line | 5310 S. BROADWAY 6-101
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City | ENGELWOOD
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State | CO
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Zip | 80113
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Country | US
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Telephone | 281-462-1285
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Fax | 281-462-1554
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Provider Business Mailing Address
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Address Line | PO BOX 3101
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City | LITTLETON
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State | CO
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Zip | 80116
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Country | US
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Telephone | 281-462-1285
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Fax | 281-462-1554
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Authorized Official
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Title or Position | OWNER
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Name | DWIGHT LENOX II
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Credential | CST/CSFA
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Telephone | 281-462-1285
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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 |
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License Number State |
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