Provider Demographics
NPI:1881153435
Name:THIRD DAY ORTHOPEDICS & SPORTS MEDICINE PLLC
Entity type:Organization
Organization Name:THIRD DAY ORTHOPEDICS & SPORTS MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:SPAW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:979-224-8422
Mailing Address - Street 1:1451 GREENS PRAIRIE RD W STE 200
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-8794
Mailing Address - Country:US
Mailing Address - Phone:979-224-8422
Mailing Address - Fax:
Practice Address - Street 1:1451 GREENS PRAIRIE RD W STE 200
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-8794
Practice Address - Country:US
Practice Address - Phone:979-224-8422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-13
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty