Organization
ADVANCED ORTHOPAEDICS AND SPORTS MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. F. LINCOLN AVERY MD (CHIEF ADMINISTRATOR)
(207) 332-5462
Entity
Organization
Contact information
Practice address
100 FODEN RD, SUITE 307, SOUTH PORTLAND, ME 04106-2327
(207) 332-5462
(207) 774-6501
Mailing address
100 BRICKHILL AVE, SUITE 303, SOUTH PORTLAND, ME 04106-1999
(207) 773-0040
(207) 774-6501
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
012274
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
432843300
—
ME
Enumeration date
01/10/2008
Last updated
11/29/2011
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