# BONE & JOINT SPECIALISTS, PC

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

## Provider details

- **NPI number:** 1790189850
- **Authorized official:** CORI JOHNSON (DIVISION MANAGER)
- **Authorized official phone:** (219) 795-3360

## Contact information

- **Practice address:** 9001 BROADWAY, MERRILLVILLE, IN 46410-7041
- **Practice address phone:** (219) 795-3360
- **Practice address fax:** (219) 472-0494
- **Mailing address:** 9001 BROADWAY, MERRILLVILLE, IN 46410-7041
- **Mailing address phone:** (219) 795-3360
- **Mailing address fax:** (219) 472-0494

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 10001727A | IN | Yes |

## Other

- **Enumeration date:** 10/20/2014
- **Last updated:** 10/20/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 10001727A | STATE LICENSE | IN |