Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | OS 013966 | PA |
NPI | 1528219334 |
---|---|
Provider Name | Dr. James Nace |
First Address | Philadelphia, PA 19128-3613 |
Second Address | Philadelphia, PA 19131 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2008 |
Last Update Date | 10/10/2008 |