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Organization

OPTIM ORTHOPEDICS, LLC

Active
Parent organization
OPTIM ORTHOPEDICS, LLC
Other names
Optim Orthopedics
Organization subpart
Yes

Provider details

NPI number
Legal business name
OPTIM ORTHOPEDICS, LLC
Authorized official
MR. MARK W MILLER (PRACTICE ADMINISTRATOR)
(912) 644-1626
Entity
Organization

Contact information

Practice address
3345 US HIGHWAY 84, SUITE 100, BLACKSHEAR, GA 31516-2159
(912) 629-6942
(912) 644-5280
Mailing address
210 E DERENNE AVE, ATTN.: PROVIDER ENROLLMENT, SAVANNAH, GA 31405-6736
(912) 644-1626
(912) 644-5260

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary

Other

Enumeration date
08/24/2015
Last updated
08/24/2015
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