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
111 HIGHWAY 70 E STE 103, DICKSON, TN 37055-2080
(615) 455-1966
(615) 740-0259
Mailing address
PO BOX 370, FORTSON, GA 31808-0370
(706) 324-6661
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0922510016
MEDICARE DME
TN
05
—
3707844
—
TN
Enumeration date
05/11/2017
Last updated
09/19/2018
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