Organization
PREMIER ORTHOPAEDIC SURGERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WANDA HAYES (OFFICE MANAGER)
(678) 513-8111
Entity
Organization
Contact information
Practice address
7360 MCGINNIS FERRY RD, SUITE E, SUWANEE, GA 30024-6603
(678) 513-8111
(678) 990-1956
Mailing address
7360 MCGINNIS FERRY RD, SUITE E, SUWANEE, GA 30024-6603
(678) 513-8111
(678) 990-1956
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300044591A
—
GA
Enumeration date
12/06/2006
Last updated
08/15/2008
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