Healthcare Provider Details

I. General information

NPI: 1447588850
Provider Name (Legal Business Name): AFFINITY ORTHOPEDIC SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2009
Last Update Date: 11/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 MONTCLAIR RD
BIRMINGHAM AL
35213-1964
US

IV. Provider business mailing address

720 MONTCLAIR RD
BIRMINGHAM AL
35213-1964
US

V. Phone/Fax

Practice location:
  • Phone: 205-397-5200
  • Fax: 205-397-5220
Mailing address:
  • Phone: 205-397-5200
  • Fax: 205-397-5220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RS0010X
TaxonomySports Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DEBBIE BREWER
Title or Position: DIRECTOR / AUTHORIZED OFFICIAL
Credential:
Phone: 615-465-7626