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Organization
GRANITE CITY ORTHOPEDIC PHYSICIANS COMPANY LLC
Active
Organization
GRANITE CITY ORTHOPEDIC PHYSICIANS COMPANY LLC
Active
Other names
ILLINOIS SW ORTHOPEDICS LTD
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA J FEY (SR. DIRECTOR PHYSICIAN REV CYCLE)
(615) 221-3641
Entity
Organization
Contact information
Practice address
4802 S STATE ROUTE 159, GLEN CARBON, IL 62034-1904
(618) 288-4388
(618) 288-4927
Mailing address
1573 MALLORY LN STE 100, BRENTWOOD, TN 37027-2895
(615) 221-1400
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
—
NULL
Other
Enumeration date
05/20/2006
Last updated
07/07/2023
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