MEDICARE: WAYNE REGIONAL ORTHOPAEDICS PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM2500X	Medical Specialty Clinic/Center

General Provider Information

NPI Number	:	1154369098
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WAYNE REGIONAL ORTHOPAEDICS PLLC

Provider Business Mailing Address
First Line	:	PO BOX 897
Second Line	:	4425 OLD RIDGE RD STE 100
City	:	WILLIAMSON
State	:	NY
Zip	:	14589-0897
Country	:	US
Telephone Number	:	315-589-2800
Fax Number	:	315-589-4420

Provider Business Practice Location Address
First Line	:	4425 OLD RIDGE RD
Second Line	:	STE 100
City	:	WILLIAMSON
State	:	NY
Zip	:	14589-0897
Country	:	US
Telephone Number	:	315-589-2800
Fax Number	:	315-589-4420

Authorized Official
Title or Position	:	PHYSICIAN OWNER
Name	:	FREDERICK A KAEMPFFE
Credential	:	MD
Telephone Number	:	315-589-2800

Provider Enumeration Date	:	06/03/2006
Last Update Date	:	04/29/2009

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