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General NPI Number Information
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NPI Number | 1689627572
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Entity Type | Organization
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Legal Business Name | PREMIER ORTHOPEDIC SURGERY, INC.
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 02/23/2017
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Provider Practice Location Address
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Address Line | 7938 AL HWY 69 SUITE 100
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City | GUNTERSVILLE
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State | AL
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Zip | 35976
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Country | US
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Telephone | 256-571-8445
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Fax |
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Provider Business Mailing Address
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Address Line | 7938 AL HWY 69 SUITE 100
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City | GUNTERSVILLE
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State | AL
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Zip | 35976-7119
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Country | US
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Telephone | 256-571-8445
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Fax | 256-571-8447
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MATTHEW PATRICK SMITH
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Credential | D.O.
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Telephone | 256-505-7066
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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 | DO930
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License Number State | AL
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