Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 30290 | AZ |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 30290 | AZ |
NPI | 1144297250 |
---|---|
Provider Name | Joseph M Scoggin |
First Address | Phoenix, AZ 85023-1266 |
Second Address | Mesa, AZ 85202-4712 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2006 |
Last Update Date | 24/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G26900 | (02) | AZ |