Provider Demographics
NPI:1417287780
Name:KEYSTONE ORTHOPAEDIC SPECIALISTS
Entity Type:Organization
Organization Name:KEYSTONE ORTHOPAEDIC SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:B
Authorized Official - Last Name:REES
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:610-376-8671
Mailing Address - Street 1:PO BOX 9202
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-9202
Mailing Address - Country:US
Mailing Address - Phone:610-376-8671
Mailing Address - Fax:610-376-6387
Practice Address - Street 1:301 S 7TH AVE
Practice Address - Street 2:SUITE 3220
Practice Address - City:WEST READING
Practice Address - State:PA
Practice Address - Zip Code:19611-1410
Practice Address - Country:US
Practice Address - Phone:610-376-8671
Practice Address - Fax:610-376-6387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-08
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA6396440002Medicare NSC