Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | A145434 | CA |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 61091 | AZ |
NPI | 1184007478 |
---|---|
Provider Name | Dr. Joseph Kamil Antonios |
First Address | Scottsdale, AZ 85259-5452 |
Second Address | Scottsdale, AZ 85259-5452 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2015 |
Last Update Date | 03/12/2021 |