Provider Demographics
NPI:1164849485
Name:ADVANCED ORTHOPAEDIC ASSOCIATES OF PA
Entity type:Organization
Organization Name:ADVANCED ORTHOPAEDIC ASSOCIATES OF PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
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 1:105 VINEYARD WAY
Practice Address - Street 2:SUITE 101
Practice Address - City:WEST GROVE
Practice Address - State:PA
Practice Address - Zip Code:19390-8849
Practice Address - Country:US
Practice Address - Phone:610-869-4830
Practice Address - Fax:610-869-4831
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVANCED ORTHOPAEDIC ASSOCIATES OF PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-03-25
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD038141E207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
448641Medicare PIN