A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level.
| Specialty | Taxonomy Code | |
|---|---|---|
| * | Preferred Provider Organization | 305R00000X |
* Indicates primary specialty
| NPI Number | 1104792852 |
| Credentials | |
| Entity | Individual |
| Enumeration date | 10/10/2025 |
| Last updated | 10/10/2025 - About 8 months ago |
| Sole proprietor1 | Yes |
| Identifiers | n/a |
| Hospital affiliation | n/a |
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.
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