Organization
OLDHAM ORTHO PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB B OLDHAM MD (OWNER)
(928) 537-8777
Entity
Organization
Contact information
Practice address
4830 HIGHWAY 260 STE 103, LAKESIDE, AZ 85929-5851
(928) 537-8777
(928) 537-1914
Mailing address
4830 HIGHWAY 260 STE 103, LAKESIDE, AZ 85929-5851
(928) 537-8777
(928) 537-1914
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
10/20/2022
Last updated
10/20/2022
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