Organization
ADVANCED MICROSURGERY OF THE SPINE, P.A.
Active
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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