BACK MOUNTAIN ORTHOPEDICS P.C. (NPI# 1073063079) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073063079 |
| Entity Type | Organization |
| Organization Name | BACK MOUNTAIN ORTHOPEDICS P.C. |
| Practice Address |
2800 Memorial Hwy Suite 1 Dallas PA 18612-1569 |
| Practice Telephone | 5706756737 |
| Practice Fax Number | 5706757882 |
| Mailing Telephone | 5706756737 |
| Mailing Fax Number | 5706757882 |
| Enumeration Date | 2016-10-13 |
| Last Update Date | 2016-10-13 |
| Authorized Official Name | DR. THOMAS WILLIAM BYRON (OWNER) |
| Authorized Official Telephone | 5706756737 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XS0106X |
Orthopaedic Surgery Specialization: Hand Surgery |
MD024634E | PA | Allopathic & Osteopathic Physicians |
| Street Address |
2800 MEMORIAL HWY SUITE 1 |
| City | DALLAS |
| State | PA |
| Zip Code | 18612-1569 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659302206 | Thomas W Byron | Orthopaedic Surgery | 2800 Memorial Hwy, Dallas, PA 18612-1569 | 2006-07-05 |
| 1437500998 | Susko Therapy LLC | Clinic/Center | 2800 Memorial Hwy, Suite 5, Dallas, PA 18612-1569 | 2016-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487009882 | Jacqueline Patricia O'brien | Occupational Therapist | 345 Lake Louise Rd, Dallas, PA 18612 | 2016-05-04 |
| 1164772927 | Katie M Ferguson | Pharmacist | 26 Dallas Shopping Center Memorial Highway, Dallas, PA 18612 | 2012-09-19 |
| 1619235892 | Crista Zern | Physical Therapist | 4 East Center Hill Road, Dallas, PA 18612 | 2012-04-25 |
| 1336423631 | Angela Mary Evans | Nurse Practitioner | 301 Lake Street, Misericordia University's Health & Wellness Center, Dallas, PA 18612 | 2011-10-05 |
| 1376835868 | Peter Frederick Casterline | Surgery | 5 Old Well Lane, Dallas, PA 18612 | 2011-05-03 |
| 1336386051 | Judy A Williams | Speech-Language Pathologist | 368 Tioga Avenue, Kingston, PA 18612 | 2009-01-16 |
| 1013195015 | Joseph John Kowalski | Psychiatry & Neurology | 2 Birch Hill Lane, Dallas, PA 18612 | 2008-02-01 |
| 1063621233 | Back Mountain Pediatrics | Clinical Medical Laboratory | 550 Memorial Highway, Dallas, PA 18612 | 2007-05-22 |
| 1760699177 | Leonard M Evans | Internal Medicine | 1806 Country Club Apartments, Dallas, PA 18612 | 2007-05-16 |
| 1417170549 | Clem-mar House, Inc. | Substance Abuse Rehabilitation Facility | 2860 State Route 309, Dallas, PA 18612 | 2007-04-10 |
| Find all providers in zip 18612 | ||||
| Taxonomy Code | 207XS0106X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Hand Surgery |
| An orthopaedic surgeon trained in the investigation, preservation and restoration by medical, surgical and rehabilitative means of all structures of the upper extremity directly affecting the form and function of the hand and wrist. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912552415 | Kyoto Medical Services, Pllc | Orthopaedic Surgery | 12890 Hillcrest Plaza Drive, Suite K111, Dallas, TX 75230 | 2019-08-02 |
| 1760740930 | Jessica Wingfield | Orthopaedic Surgery | 12230 Coit Rd Ste 100, Dallas, TX 75251-2323 | 2012-04-25 |
| 1841596772 | Charity Mamaa Ogunro | Orthopaedic Surgery | 3670 W Wheatland Rd, Dallas, TX 75237-3462 | 2011-02-10 |
| 1598068835 | Michael Vernon Doyle Md | Orthopaedic Surgery | 8220 Walnut Hill Ln Ste 606, Dallas, TX 75231-4424 | 2010-12-08 |
| 1851577308 | Nilpesh Mahesh Patel | Orthopaedic Surgery | 8585 N Stemmons Fwy # 105, Dallas, TX 75247-3836 | 2008-01-15 |
| 1659302206 | Thomas W Byron | Orthopaedic Surgery | 2800 Memorial Hwy, Dallas, PA 18612-1569 | 2006-07-05 |
| 1255311601 | Michael V Doyle | Orthopaedic Surgery | 8220 Walnut Hill Lane, # 606, Dallas, TX 75231 | 2006-01-20 |
| 1841273562 | Olayinka Ogunro | Orthopaedic Surgery | 7989 W Virginia Dr Ste 105, # 105, Dallas, TX 75237-3837 | 2005-11-28 |
| 1063415883 | Guy Kenneth Driggs | Orthopaedic Surgery | 5920 Forest Park Rd, Ste 530, Dallas, TX 75235-6413 | 2005-05-24 |
| 1962968081 | Kimberly Mezera Md Pllc | Orthopaedic Surgery | 9301 N Central Expy Ste 300, Dallas, TX 75231-0804 | 2019-02-13 |
| Find all providers in DALLAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.