Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 11807 | AZ |
NPI | 1023057411 |
---|---|
Provider Name | Dr. Jon Edwin Gelsey |
First Address | Phoenix, AZ 85027-3943 |
Second Address | Sun City West, AZ 85375-5286 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2006 |
Last Update Date | 22/08/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
230748 | (05) | AZ |
C99526 | (02) | AZ |