Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | MD23769 | OR |
NPI | 1508855818 |
---|---|
Provider Name | John-Paul Veri |
First Address | Medford, OR 97504-8343 |
Second Address | Medford, OR 97504-8343 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2005 |
Last Update Date | 06/10/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001920 | (05) | OR |
286588 | (05) | OR |
H72590 | (02) |