Healthcare Provider Details
I. General information
NPI: 1871655167
Provider Name (Legal Business Name): ASSOCIATES IN ORTHOPEDICS & SPORTS MEDICINE PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/14/2006
Last Update Date: 01/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1104 PROFESSIONAL BLVD
DALTON GA
30720-2588
US
IV. Provider business mailing address
1104 PROFESSIONAL BLVD
DALTON GA
30720-2588
US
V. Phone/Fax
- Phone: 706-226-5533
- Fax: 706-428-0033
- Phone: 706-226-5533
- Fax: 706-428-0033
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | 0427700001 |
| License Number State | GA |
VIII. Authorized Official
Name: DR.
JAMES
MITCHELL
FRIX
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 706-226-5533