Provider Demographics
NPI:1740425842
Name:ADVANCED ORTHOPAEDIC ASSOC OF PA
Entity Type:Organization
Organization Name:ADVANCED ORTHOPAEDIC ASSOC OF PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:LYONS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-280-9999
Mailing Address - Street 1:479 THOMAS JONES WAY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2580
Mailing Address - Country:US
Mailing Address - Phone:610-280-9999
Mailing Address - Fax:610-363-8914
Practice Address - Street 1:479 THOMAS JONES WAY
Practice Address - Street 2:SUITE 300
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2580
Practice Address - Country:US
Practice Address - Phone:610-280-9999
Practice Address - Fax:610-363-8914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-04
Last Update Date:2008-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100728263Medicaid
PA1007282630005Medicaid
PA100728263Medicaid