Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 2206 | TN |
N | 207X00000X | Orthopaedic Surgeon | OS9714 | FL |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 654 | NE |
NPI | 1407885882 |
---|---|
Provider Name | Stephen A Purvis |
First Address | Baltimore, MD 21297-3087 |
Second Address | Greeneville, TN 37743-7202 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2006 |
Last Update Date | 10/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1521019 | (05) | TN |
1811917628 | MEDICARE GRP NPI # (01) | FL |
4282077 | BCBST (01) | TN |
G13473 | (02) | |
K4964 | MEDICARE GRP # (01) | FL |
P00420317 | RAILROAD MEDICARE (01) | FL |