Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | 36029 | CO |
NPI | 1154373850 |
---|---|
Provider Name | Dr. Jim Youssef |
First Address | Durango, CO 81301-8840 |
Second Address | Durango, CO 81301-7300 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2006 |
Last Update Date | 14/07/2020 |