Organization
PREMIER ORTHOPEDICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES TYLER VESTILE (OWNER)
(317) 519-8038
Entity
Organization
Contact information
Practice address
239 ASH ST STE B, TIPTON, IN 46072-1752
(765) 481-1814
Mailing address
20958 PROMONTORY LN, WESTFIELD, IN 46074-7410
(317) 441-7981
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
261QP1100X
Podiatric Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300075220
—
IN
Enumeration date
12/22/2022
Last updated
05/22/2023
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