Provider Demographics
NPI:1013168947
Name:AKSU ORTHOPAEDIC & SPINE CENTER, PC
Entity Type:Organization
Organization Name:AKSU ORTHOPAEDIC & SPINE CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KENAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:AKSU
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:610-858-4941
Mailing Address - Street 1:390 WATERLOO BLVD
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2603
Mailing Address - Country:US
Mailing Address - Phone:610-858-4941
Mailing Address - Fax:
Practice Address - Street 1:390 WATERLOO BLVD
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2603
Practice Address - Country:US
Practice Address - Phone:610-858-4941
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-09
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS008530L207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G70754Medicare UPIN