# REPUBLIC BRAIN SPINE AND ORTHOPEDIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558088682
- **Authorized official:** SETH JACKNOWITZ (CRO)
- **Authorized official phone:** (561) 699-7479

## Contact information

- **Practice address:** 2291 PACHECO ST, CONCORD, CA 94520-2015
- **Practice address phone:** (925) 397-9480
- **Mailing address:** 4400 STATE HIGHWAY 121 STE 405, LEWISVILLE, TX 75056-4952
- **Mailing address phone:** (469) 817-9611

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/19/2022
- **Last updated:** 10/19/2022