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General NPI Number Information
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NPI Number | 1053917344
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Entity Type | Organization
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Legal Business Name | ORTHOSPORTS ASSOCIATES, LLC
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Dates
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Enumeration Date | 12/10/2020
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Last Update Date | 04/16/2021
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Provider Practice Location Address
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Address Line | 52 MEDICAL PARK DR E STE 220
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City | BIRMINGHAM
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State | AL
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Zip | 35235-3430
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Country | US
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Telephone | 205-838-4747
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Fax |
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Provider Business Mailing Address
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Address Line | 833 SAINT VINCENTS DR STE 403
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City | BIRMINGHAM
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State | AL
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Zip | 35205-1614
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Country | US
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Telephone | 205-939-0447
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | LORI W SILLS
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Credential |
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Telephone | 205-939-0447
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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