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General NPI Number Information
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NPI Number | 1639994544
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Entity Type | Organization
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Legal Business Name | ORTHOCINCY ORTHOPAEDICS & SPORTS MEDICINE PSC
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Dates
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Enumeration Date | 11/18/2024
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 1919 STATE ST STE 424
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City | NEW ALBANY
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State | IN
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Zip | 47150-6808
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Country | US
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Telephone | 502-364-0902
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Fax | 502-364-0099
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Provider Business Mailing Address
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Address Line | 560 S LOOP RD
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City | EDGEWOOD
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State | KY
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Zip | 41017-3405
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Country | US
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Telephone | 859-301-2663
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Fax | 859-817-7848
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Authorized Official
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Title or Position | CEO
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Name | JOANN MARIE REIS
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Credential |
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Telephone | 859-301-2663
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207XS0114X
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Taxonomy Name | Adult Reconstructive Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 207XX0004X
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Taxonomy Name | Orthopaedic Foot and Ankle Surgery Physician
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License Number |
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License Number State |
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Taxonomy #9
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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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