Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | PO 3092 | FL |
NPI | 1194752659 |
---|---|
Provider Name | Dr. Philip Jay Organ |
First Address | Naples, FL 34114-3625 |
Second Address | Naples, FL 34114-3625 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 17/06/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
65866Y | MEDICARE PTAN (01) | FL |
T50690 | (02) | FL |