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PROVIDENCE PHYSICIAN SERVICES CO NPI 1417124488


NPI Information

NPI: 1417124488
Provider Name: PROVIDENCE PHYSICIAN SERVICES CO
Classification: Orthopaedic Surgery - 207XX0801X
Entity Type: Organization

Specialization: Orthopaedic Trauma

Address:
820 S MCCLELLAN ST
STE 300B
SPOKANE, WA
ZIP 99204
Phone: (509) 464-7880
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PROVIDENCE PHYSICIAN SERVICES CO is an orthopaedic trauma orthopaedic surgery in Spokane, WA. The provider is recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic trauma surgeons deal with the evaluation and management of acute orthopaedic injuries, evaluation and treatment of post-traumatic deformities and nonunions, acute and delayed reconstruction of pelvic and acetabular fractures, as well as osteotomy in the adult hip for treatment of hip arthritis. PROVIDENCE PHYSICIAN SERVICES CO NPI is 1417124488. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

820 S MCCLELLAN ST
STE 300B
SPOKANE, WA
ZIP 99204-246
Phone: (509) 464-7880
Fax: (509) 838-0721

The provider's authorized official is Sean M Douglas .
The authorized official title is Cfo and has the following contact phone number (509) 474-2225.

The enumeration date for this NPI number is 5/9/2008 and was last updated on 2/28/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207XX0801XOrthopaedic SurgeryOrthopaedic Trauma600503827WASHINGTONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
14571750007MEDICARE NSCWASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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