John Warren Axline, M.D.
Individual provider Active NPI Orthopaedic Surgery Physician · Fairfield, CT
NPI 1972650281 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1972650281
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthopaedic Surgery Physician 207X00000X
- License
- 019427 (CT)
- Practice address
- 401 Silver Spring Rd
Fairfield, CT 06824-1944 - Phone
- (203) 259-2427
- Fax
- (203) 372-1985
- NPI assigned
- Jan 5, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019427 | CT | MD | Orthopaedic Surgery Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 019427 | CT | Yes |
Addresses
Primary practice location
401 Silver Spring Rd
Fairfield, CT 06824-1944
Mailing address
401 Silver Spring Rd
Fairfield, CT 06824-1944
Phone (203) 259-2427
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All providers in Fairfield, CT · Orthopaedic Surgery Physician in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.