Organization
JOHN PETER SMITH HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL WAGNER M.D. (ORTHOPEDIC PROGRAM DIRECTOR)
(817) 927-1370
Entity
Organization
Contact information
Practice address
1500 S MAIN ST, FORT WORTH, TX 76104-4917
(817) 927-1370
Mailing address
1500 S MAIN ST, FORT WORTH, TX 76104-4917
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
BP10043964
TX
Other
Enumeration date
05/15/2014
Last updated
05/15/2014
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