Provider Demographics
NPI:1841257433
Name:JAMISON, JOHN P (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:P
Last Name:JAMISON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:800 ORTHOPEDIC WAY
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015-1629
Mailing Address - Country:US
Mailing Address - Phone:817-375-5375
Mailing Address - Fax:817-299-1706
Practice Address - Street 1:7999 W VIRGINIA DR
Practice Address - Street 2:STE D
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-3844
Practice Address - Country:US
Practice Address - Phone:972-709-6911
Practice Address - Fax:972-298-5240
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF9616174400000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDA6807OtherRAILDROAD MEDICARE
TX8B4373OtherPALMETTO GBA
TX8K9830OtherBLUE CROSS
TX8B4373OtherPALMETTO GBA
TXDA6807OtherRAILDROAD MEDICARE
TX5176840001Medicare NSC