Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 211796-1 | NY |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 35.078735 | OH |
NPI | 1053395640 |
---|---|
Provider Name | Dr. John J. Sharkey |
First Address | Columbus, OH 43203-1278 |
Second Address | Columbus, OH 43203-1278 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2005 |
Last Update Date | 06/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2204439 | (05) | OH |
H25822 | (02) | NY |