Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 076954 | GA |
N | 207X00000X | Orthopaedic Surgeon | MD426437 | PA |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | ME109178 | FL |
NPI | 1548290125 |
---|---|
Provider Name | Eric D. Shirley |
First Address | Jacksonville, FL 32256-0532 |
Second Address | Atlanta, GA 30329-2221 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 21/08/2019 |