Organization
PREMIER ORTHOPAEDICS & SPORTS MEDICINE, PLC
Active
Parent organization
PREMIER ORTHOPAEDICS & SPORTS MEDICINE, PLC
Other names
Hughston Clinic Orthopaedics
Organization subpart
Yes
Provider details
NPI number
Legal business name
PREMIER ORTHOPAEDICS & SPORTS MEDICINE, PLC
Authorized official
AMY BENCHWICK (DIRECTOR OF CREDENTIALING)
(706) 324-6661
Entity
Organization
Contact information
Practice address
5651 FRIST BLVD, SUITE 515, HERMITAGE, TN 37076-2054
(615) 889-3501
(615) 889-3349
Mailing address
PO BOX 370, FORTSON, GA 31808-0370
(706) 324-6661
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0922510006
MEDICARE DME
TN
Enumeration date
11/22/2006
Last updated
09/20/2018
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