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NPI Code Detail

MEDICARE: PREMIER ORTHOPAEDICS AND SPORTS MEDICINE, LLC

MEDICARE: PREMIER ORTHOPAEDICS AND SPORTS MEDICINE, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207XX0005XSports Medicine (Orthopaedic Surgery) PhysicianMD29131AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144474388
Entity Type Code : Organization
Provider Name (Legal Business Name) : PREMIER ORTHOPAEDICS AND SPORTS MEDICINE, LLC
Provider Business Mailing Address
First Line : 155 FORREST RD UNIT 1939
Second Line :
City : FORT OGLETHORPE
State : GA
Zip : 30742-8201
Country : US
Telephone Number : 256-574-2663
Fax Number : 855-823-7569
Provider Business Practice Location Address
First Line : 380 WOODS COVE RD
Second Line : SUITE A
City : SCOTTSBORO
State : AL
Zip : 35768-2428
Country : US
Telephone Number : 256-574-2663
Fax Number : 256-574-2664
Authorized Official
Title or Position : MEMBER
Name : DR. MASOUD HAMIDIAN
Credential : MD
Telephone Number : 256-574-2663
Provider Enumeration Date : 11/14/2008
Last Update Date : 01/16/2026

Similar Medicare Providers

1699929703 — PREMIER ORTHOPAEDICS AND SPORTS MEDICINE, LLC
Practice Location Address:
380 WOODS COVE RD , SUITE A
SCOTTSBORO, AL
35768-2428
Practice Phone: 256-574-2663
Practice Fax: 256-574-2664
1316933997 — JAMES WOODROW JOHNT MD
Practice Location Address:
380 WOODS COVE RD
SCOTTSBORO, AL
35768-2428
Practice Phone: 256-218-3860
Practice Fax: 256-218-3817
1770542573 — SLEEP MEDICINE PC
Practice Location Address:
380 WOODS COVE RD
SCOTTSBORO, AL
35768-2428
Practice Phone: 256-218-3639
Practice Fax:
1316995301 — DR. JOHN CHARLES LUCKE M.D.
Practice Location Address:
380 WOODS COVE RD
SCOTTSBORO, AL
35768-2428
Practice Phone: 256-259-4444
Practice Fax: 256-218-3536
1174567648 — MS. LINDA R. WINDSOR C.R.N.P
Practice Location Address:
380 WOODS COVE RD
SCOTTSBORO, AL
35768-2428
Practice Phone: 256-259-4444
Practice Fax:
1669416053 — MS. KATHLEEN GLOR CURRY C.R.N.P.
Practice Location Address:
380 WOODS COVE RD
SCOTTSBORO, AL
35768-2428
Practice Phone: 256-259-4444
Practice Fax:

Directions to “PREMIER ORTHOPAEDICS AND SPORTS MEDICINE, LLC ” Practice Location

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