Provider Demographics
NPI:1043276884
Name:ORTHOPAEDIC SOLUTIONS AND SPORTS MEDICINE CENTER PA
Entity Type:Organization
Organization Name:ORTHOPAEDIC SOLUTIONS AND SPORTS MEDICINE CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAYLAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:PARIKH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-891-4202
Mailing Address - Street 1:721 TILGHMAN DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DUNN
Mailing Address - State:NC
Mailing Address - Zip Code:28334-6063
Mailing Address - Country:US
Mailing Address - Phone:910-891-4202
Mailing Address - Fax:910-891-2602
Practice Address - Street 1:721 TILGHMAN DR
Practice Address - Street 2:SUITE 100
Practice Address - City:DUNN
Practice Address - State:NC
Practice Address - Zip Code:28334-6063
Practice Address - Country:US
Practice Address - Phone:910-891-4202
Practice Address - Fax:910-891-2602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-21
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9501044207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2000034387OtherMEDICARE RR
NCAS23685210001OtherCIGNA
NC0938858OtherUNITED HEALTHCARE
NC153900292OtherTRICARE HEALTHNET
NC59032OtherMEDCOST
NC017XJOtherBCBSNC
NC5903902Medicaid
NC5327243OtherAETNA
NC59032OtherMEDCOST