Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | BP10016967 | TX |
Y | 207XS0117X | Orthopaedic Spine Surgeon | MD437115 | PA |
NPI | 1003071010 |
---|---|
Provider Name | Dr. Kristen E Radcliff |
First Address | Philadelphia, PA 19107-4414 |
Second Address | Philadelphia, PA 19107-4216 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2008 |
Last Update Date | 10/11/2015 |