# PREMIER ORTHOPAEDIC AND SPORTS MEDICINE ASSOCIATES LTD

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

## Provider details

- **NPI number:** 1770802969
- **Authorized official:** KIM STOTT (ADMINISTRATIVE MANAGER)
- **Authorized official phone:** (610) 359-5664

## Contact information

- **Practice address:** 525 W CHESTER PIKE, STE 203, HAVERTOWN, PA 19083-4500
- **Practice address phone:** (610) 789-7767
- **Practice address fax:** (610) 789-7768
- **Mailing address:** 525 W CHESTER PIKE, STE 203, HAVERTOWN, PA 19083-4500
- **Mailing address phone:** (610) 789-7767
- **Mailing address fax:** (610) 789-7768

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | MD070801L | PA | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | MD430669 | PA | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | OS009727L | PA | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |

## Other

- **Enumeration date:** 05/27/2010
- **Last updated:** 11/18/2013