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Organization
BONE & JOINT SPECIALISTS, PC
Active
Organization
BONE & JOINT SPECIALISTS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CORI JOHNSON (DIVISION MANAGER)
(219) 795-3360
Entity
Organization
Contact information
Practice address
9001 BROADWAY, MERRILLVILLE, IN 46410-7041
(219) 795-3360
(219) 472-0494
Mailing address
9001 BROADWAY, MERRILLVILLE, IN 46410-7041
(219) 795-3360
(219) 472-0494
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10001727A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10001727A
STATE LICENSE
IN
Enumeration date
10/20/2014
Last updated
10/20/2014
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