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General NPI Number Information
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NPI Number | 1922158047
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Entity Type | Organization
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Legal Business Name | FIVE RIVERS ORTHOPAEDIC ASSOCIATES, PC
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 07/23/2009
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Provider Practice Location Address
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Address Line | 231 S FAIRMONT AVE
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City | MORRISTOWN
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State | TN
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Zip | 37813-2036
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Country | US
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Telephone | 423-587-3487
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Fax | 423-586-7281
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Provider Business Mailing Address
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Address Line | PO BOX 460
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City | MORRISTOWN
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State | TN
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Zip | 37815-0460
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Country | US
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Telephone | 423-587-3487
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Fax | 423-586-7281
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Authorized Official
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Title or Position | PRESIDENT
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Name | WAYNE L. MCLEMORE
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Credential | M.D.
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Telephone | 423-587-3487
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | 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 | 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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