Provider Demographics
NPI:1629083076
Name:BONE & JOINT SPECIALISTS, P.C.
Entity Type:Organization
Organization Name:BONE & JOINT SPECIALISTS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:J
Authorized Official - Last Name:HAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-795-3360
Mailing Address - Street 1:9001 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-7039
Mailing Address - Country:US
Mailing Address - Phone:219-795-3360
Mailing Address - Fax:219-756-6500
Practice Address - Street 1:9001 BROADWAY
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-7039
Practice Address - Country:US
Practice Address - Phone:219-795-3360
Practice Address - Fax:219-756-6500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP00276218OtherRAILROAD MEDICARE
IN5426631OtherAETNA - KENNETH J. HAM, MD
IN611265200OtherDEPARTMENT OF LABOR
IN200536660Medicaid
IN000000383653OtherANTHEM BCBS
IN4611377OtherAETNA - JOSEPH F. SCHWARTZ, MD
IN90001242OtherBCBS OF ILLINOIS
INP00276218OtherRAILROAD MEDICARE
IN4611377OtherAETNA - JOSEPH F. SCHWARTZ, MD