Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 0101266891 | VA |
N | 207X00000X | Orthopaedic Surgeon | MD047266 | DC |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | 0101266891 | VA |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | MD047266 | DC |
Y | 207XS0106X | Orthopaedic Hand Surgeon | 0101266891 | VA |
N | 207XS0106X | Orthopaedic Hand Surgeon | MD047266 | DC |
NPI | 1487910345 |
---|---|
Provider Name | Mr. Joseph Paul Letzelter III |
First Address | Fairfax, VA 22031-2241 |
Second Address | Fairfax, VA 22031-2241 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2012 |
Last Update Date | 19/10/2020 |