# GRANITE CITY ORTHOPEDIC PHYSICIANS COMPANY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407022361
- **Authorized official:** DEBBIE BREWER (DIRECTOR)
- **Authorized official phone:** (615) 465-7000

## Contact information

- **Practice address:** 650 W TAYLOR ST, VANDALIA, IL 62471-1227
- **Practice address phone:** (618) 283-5531
- **Practice address fax:** (618) 283-4652
- **Mailing address:** 4000 MERIDIAN BLVD, ATTN: DEBBIE BREWER, FRANKLIN, TN 37067-6325
- **Mailing address phone:** (615) 465-7000
- **Mailing address fax:** (615) 465-3007

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/01/2008
- **Last updated:** 05/01/2008