Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 35890 | GA |
NPI | 1003886136 |
---|---|
Provider Name | Phillip D Hajek |
First Address | Albany, GA 31708-1367 |
Second Address | Albany, GA 31707-3183 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2006 |
Last Update Date | 26/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
35890 | LICENSE NUMBER (01) | GA |
F41795 | (02) | GA |