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Organization

ORTHOPAEDICS & SPORTS MEDICINE OWENSBORO PSC

Active
Other names
Advanced Center for Orthopedics & Sports Medicine
Organization subpart
No

Provider details

NPI number
Authorized official
CHARLES A MILEM MD (PRESIDENT)
(270) 926-4100
Entity
Organization

Contact information

Practice address
2780 FREDERICA ST, OWENSBORO, KY 42301-5442
(270) 926-4100
(270) 648-4678
Mailing address
2780 FREDERICA ST, OWENSBORO, KY 42301-5442
(270) 926-4100
(270) 684-4678

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
207QS0010X
Sports Medicine (Family Medicine) Physician
207X00000X
Orthopaedic Surgery Physician
Primary
KY
207XS0106X
Orthopaedic Hand Surgery Physician
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
208100000X
Physical Medicine & Rehabilitation Physician
213ES0103X
Foot & Ankle Surgery Podiatrist
00263
KY
225100000X
Physical Therapist
KY
225X00000X
Occupational Therapist
KY
363A00000X
Physician Assistant
KY
363L00000X
Nurse Practitioner
KY
363LF0000X
Family Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
65923062
KY
05
7100221930
KY
Enumeration date
09/26/2006
Last updated
10/31/2024
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