MEDICARE: MAKEFIELD ORTHOPAEDICS PC

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	207X00000X	Orthopaedic Surgery Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CJ0071	OTHER	PA	TRAVELERS MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	600389	OTHER		HIGHMARK BS

General Provider Information

NPI Number	:	1841261419
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAKEFIELD ORTHOPAEDICS PC

Provider Business Mailing Address
First Line	:	111 FLORAL VALE BLVD
Second Line	:	SUITE B
City	:	YARDLEY
State	:	PA
Zip	:	19067-5522
Country	:	US
Telephone Number	:	267-757-0560
Fax Number	:	267-757-0565

Provider Business Practice Location Address
First Line	:	111 FLORAL VALE BLVD
Second Line	:	SUITE B
City	:	YARDLEY
State	:	PA
Zip	:	19067-5522
Country	:	US
Telephone Number	:	267-757-0560
Fax Number	:	267-757-0565

Authorized Official
Title or Position	:	PARTNER
Name	:	JOHN AVALLONE
Credential	:	DO
Telephone Number	:	267-757-0560

Provider Enumeration Date	:	01/31/2006
Last Update Date	:	04/07/2010

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Directions to “MAKEFIELD ORTHOPAEDICS PC ” Practice Location

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