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NPI Code Detail

MEDICARE: KINNEBREW ORTHOPEDICS & SPORTS MEDICINE, PC

MEDICARE: KINNEBREW ORTHOPEDICS & SPORTS MEDICINE, PC
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
1207X00000XOrthopaedic Surgery Physician037009GA

General Provider Information

NPI Number : 1467517391
Entity Type Code : Organization
Provider Name (Legal Business Name) : KINNEBREW ORTHOPEDICS & SPORTS MEDICINE, PC
Provider Business Mailing Address
First Line : 301 MARGIE DR
Second Line :
City : WARNER ROBINS
State : GA
Zip : 31088-7818
Country : US
Telephone Number : 478-971-1153
Fax Number : 478-971-1173
Provider Business Practice Location Address
First Line : 301 MARGIE DR
Second Line :
City : WARNER ROBINS
State : GA
Zip : 31088-7818
Country : US
Telephone Number : 478-971-1153
Fax Number : 478-971-1173
Authorized Official
Title or Position : OWNER
Name : TODD E. KINNEBREW
Credential : M.D.
Telephone Number : 478-971-1153
Provider Enumeration Date : 12/22/2006
Last Update Date : 06/02/2010

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Directions to “KINNEBREW ORTHOPEDICS & SPORTS MEDICINE, PC ” Practice Location

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