Organization
ADVANCED MICROSURGERY OF THE SPINE, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE W. WHARTON MD (PRESIDENT)
(214) 217-7520
Entity
Organization
Contact information
Practice address
1341 W. MOCKINGBIRD LN, MOCKINGBIRD TOWERS, SUITE 710E, DALLAS, TX 75247-6913
(214) 217-7520
(214) 217-7530
Mailing address
P.O. BOX 1322, ADDISON, TX 75001-1322
(972) 991-9950
(972) 991-4026
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
F6344
TX
207X00000X
Orthopaedic Surgery Physician
Primary
F6344
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
094847301
—
TX
05
—
137748302
—
TX
01
—
DC0230
RR MEDICARE
TX
Enumeration date
01/11/2007
Last updated
10/07/2008
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