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General NPI Number Information
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NPI Number | 1770782104
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Entity Type | Organization
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Legal Business Name | PURCHASE REGIONAL ORTHOPAEDICS PSC
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Dates
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Enumeration Date | 07/16/2007
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Last Update Date | 05/28/2008
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Provider Practice Location Address
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Address Line | 1029 MEDICAL CENTER CIR SUITE 406
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City | MAYFIELD
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State | KY
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Zip | 42066-1189
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Country | US
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Telephone | 270-251-8114
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Fax | 270-251-8115
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Provider Business Mailing Address
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Address Line | 1029 MEDICAL CENTER CIR SUITE 406
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City | MAYFIELD
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State | KY
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Zip | 42066-1189
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Country | US
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Telephone | 270-251-8114
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Fax | 270-251-8115
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Authorized Official
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Title or Position | OWNER
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Name | ERIC B METZ
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Credential | MD
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Telephone | 270-251-8114
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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 | 03053
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License Number State | KY
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