MEDICARE: PITTS BONE JOINT & SPINE CARE, PA

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01915	OTHER	NC	BCBS NC GROUP NO
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861434516
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PITTS BONE JOINT & SPINE CARE, PA

Provider Business Mailing Address
First Line	:	PO BOX 61038
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27715-1038
Country	:	US
Telephone Number	:	919-544-6318
Fax Number	:	919-544-6336

Provider Business Practice Location Address
First Line	:	400 CRUTCHFIELD ST
Second Line	:	SUITE B
City	:	DURHAM
State	:	NC
Zip	:	27704-2771
Country	:	US
Telephone Number	:	919-479-9727
Fax Number	:	919-479-9731

Authorized Official
Title or Position	:	PRESIDENT
Name	:	THEODORE M PITTS
Credential	:	MD
Telephone Number	:	919-479-9727

Provider Enumeration Date	:	06/10/2006
Last Update Date	:	03/24/2009

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Directions to “PITTS BONE JOINT & SPINE CARE, PA ” Practice Location

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