Provider Demographics
NPI:1073886073
Name:ORTHOPEDIC SERVICES LLC
Entity Type:Organization
Organization Name:ORTHOPEDIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:WALSH
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:207-446-0444
Mailing Address - Street 1:1175 MAINSAIL DR UNIT 702
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34114-8870
Mailing Address - Country:US
Mailing Address - Phone:207-446-0444
Mailing Address - Fax:239-206-2487
Practice Address - Street 1:1175 MAINSAIL DR UNIT 702
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34114-8870
Practice Address - Country:US
Practice Address - Phone:207-446-0444
Practice Address - Fax:239-206-2487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-22
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME010230261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service