Provider Demographics
NPI:1518157270
Name:BONE&JOINT SPECIALIST P.C.
Entity Type:Organization
Organization Name:BONE&JOINT SPECIALIST P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:K
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:8169-322-0688
Mailing Address - Street 1:17067 S OUTER RD
Mailing Address - Street 2:STE 200
Mailing Address - City:BELTON
Mailing Address - State:MO
Mailing Address - Zip Code:64012-2165
Mailing Address - Country:US
Mailing Address - Phone:816-322-0688
Mailing Address - Fax:816-322-4722
Practice Address - Street 1:17067 S OUTER RD
Practice Address - Street 2:STE 200
Practice Address - City:BELTON
Practice Address - State:MO
Practice Address - Zip Code:64012-2165
Practice Address - Country:US
Practice Address - Phone:816-322-0688
Practice Address - Fax:816-322-4722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-30
Last Update Date:2013-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOB400000Medicare PIN
MO0782220001Medicare NSC