MEDICARE: RIM COUNTRY SPORTS MEDICINE AND ORTHOPEDIC SURGERY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	4121	AZ

General Provider Information

NPI Number	:	1043237886
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIM COUNTRY SPORTS MEDICINE AND ORTHOPEDIC SURGERY

Provider Business Mailing Address
First Line	:	PO BOX 2051
Second Line	:
City	:	PAYSON
State	:	AZ
Zip	:	85547-2051
Country	:	US
Telephone Number	:	928-634-0665
Fax Number	:

Provider Business Practice Location Address
First Line	:	126 E MAIN ST
Second Line	:	SUITE A
City	:	PAYSON
State	:	AZ
Zip	:	85541-5488
Country	:	US
Telephone Number	:	928-472-2900
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	OLIVIA E. MORRIS
Credential	:	DO
Telephone Number	:	928-472-2900

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	08/22/2020

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Directions to “RIM COUNTRY SPORTS MEDICINE AND ORTHOPEDIC SURGERY ” Practice Location

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