Individual
DR. JACK ELIAS KAZANJIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
510 DARBY RD, HAVERTOWN, PA 19083-4630
(610) 449-6499
(610) 449-9814
Mailing address
510 DARBY RD, HAVERTOWN, PA 19083-4630
(610) 449-6499
(610) 449-9814
Taxonomy
Speciality
Code
Description
License number
State
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
OS010372L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1018681980001
—
PA
Enumeration date
07/10/2006
Last updated
09/05/2007
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