MEDICARE: RUSSELLVILLE MUSCULOSKELETAL CENTER INC.

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	207X00000X	Orthopaedic Surgery Physician	27698	AL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	L026	OTHER	AL	MEDICARE IDENTIFICATION NUMBER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063594539
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RUSSELLVILLE MUSCULOSKELETAL CENTER INC.

Provider Business Mailing Address
First Line	:	PO BOX 57
Second Line	:
City	:	RUSSELLVILLE
State	:	AL
Zip	:	35653-0057
Country	:	US
Telephone Number	:	256-332-6215
Fax Number	:	256-331-3430

Provider Business Practice Location Address
First Line	:	13150 HIGHWAY 43
Second Line	:	SUITE 12
City	:	RUSSELLVILLE
State	:	AL
Zip	:	35653-4558
Country	:	US
Telephone Number	:	256-332-6215
Fax Number	:	256-331-3430

Authorized Official
Title or Position	:	MD PRESIDENT
Name	:	DR. SAID GOTO OSMAN
Credential	:	MD
Telephone Number	:	256-332-6215

Provider Enumeration Date	:	10/20/2006
Last Update Date	:	02/16/2010

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