Provider Demographics
NPI:1528423951
Name:COMPREHENSIVE ORTHOPAEDIC, LLC
Entity type:Organization
Organization Name:COMPREHENSIVE ORTHOPAEDIC, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BACOT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:340-779-2663
Mailing Address - Street 1:PO BOX 11567
Mailing Address - Street 2:
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00801-4567
Mailing Address - Country:US
Mailing Address - Phone:340-779-2663
Mailing Address - Fax:340-779-2443
Practice Address - Street 1:SUNNY ISLE MEDICAL CENTER # 301
Practice Address - Street 2:
Practice Address - City:CHRISTIANSTED
Practice Address - State:VI
Practice Address - Zip Code:00820-4493
Practice Address - Country:US
Practice Address - Phone:340-719-2665
Practice Address - Fax:340-779-2443
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMPREHENSIVE ORTHOPAEDIC, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-12-30
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI2-6918-2L207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty