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

LicenseStateTypeSpecialty
019427CTMDOrthopaedic Surgery Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

Other providers in Fairfield, CT

All providers in Fairfield, CT · Orthopaedic Surgery Physician in Connecticut

Sources for this page

Verify at the official NPI Registry.