Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | SC002200L | PA |
NPI | 1063414373 |
---|---|
Provider Name | Dr. John A Pron |
First Address | Media, PA 19063-5136 |
Second Address | Media, PA 19063-5136 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2005 |
Last Update Date | 06/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001018171 | (05) | PA |
T27698 | (02) | PA |