Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | ME114075 | FL |
NPI | 1205008109 |
---|---|
Provider Name | Jason Billinghurst |
First Address | West Palm Beach, FL 33407-3209 |
Second Address | West Palm Beach, FL 33407-3209 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2008 |
Last Update Date | 25/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
ME114075 | FLORIDA MEDICAL LICENSE (01) | FL |