Basic Information
| Provider Information | |||||||||
| NPI: | 1578840658 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HJORTH | ||||||||
| FirstName: | JAMES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 E CARROLL ST | ||||||||
| Address2: | |||||||||
| City: | SALISBURY | ||||||||
| State: | MD | ||||||||
| PostalCode: | 218015422 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4105466400 | ||||||||
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| Practice Location | |||||||||
| Address1: | 30265 COMMERCE DR UNIT 103 | ||||||||
| Address2: | |||||||||
| City: | MILLSBORO | ||||||||
| State: | DE | ||||||||
| PostalCode: | 199663594 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3029903280 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/03/2011 | ||||||||
| LastUpdateDate: | 09/15/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2255A2300X | 7813419-4810 | UT | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Specialist/Technologist | Athletic Trainer | 363AS0400X | MD | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
ID Information
| ID | Type | State | Issuer | Description | 2000005131 | 01 | BOC-ATC | OTHER |