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General NPI Number Information
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NPI Number | 1962991497
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Entity Type | Individual
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Provider Name | DR. JOHN ADAM DRISCOLL
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Gender | Male
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Dates
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Enumeration Date | 05/10/2018
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Last Update Date | 09/23/2024
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Provider Practice Location Address
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Address Line | 601 JOHN ST STE M-424
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City | KALAMAZOO
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State | MI
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Zip | 49007-5354
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Country | US
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Telephone | 855-618-2676
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Fax |
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Provider Business Mailing Address
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Address Line | 1722 N ALEXANDER AVE
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City | ROYAL OAK
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State | MI
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Zip | 48067-3659
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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 |
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Name |
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Credential |
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Telephone |
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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 | 4301505420
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License Number State | MI
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