Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 35055257 | OH |
N | 207XS0106X | Orthopaedic Hand Surgeon | 35055257 | OH |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 35055257 | OH |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 35055257 | OH |
NPI | 1548255540 |
---|---|
Provider Name | Dr. Jeffrey Mariano Laporte |
First Address | Missoula, MT 59808-1811 |
Second Address | Missoula, MT 59808-1811 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2005 |
Last Update Date | 25/08/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E76414 | (02) | OH |