Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 8706 | AZ |
NPI | 1013978386 |
---|---|
Provider Name | Dr. John Anthony Soscia |
First Address | Phoenix, AZ 85020-2439 |
Second Address | Phoenix, AZ 85020-2439 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
222208 | (05) | AZ |
B75975 | (02) | AZ |