Organization
GRANITE CITY ORTHOPEDIC PHYSICIANS COMPANY LLC
Active
Other names
ILLINOIS SW ORTHOPEDICS LTD
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA J FEY (SR. DIRECTOR PHYSICIAN REV CYCLE)
(615) 221-3641
Entity
Organization
Contact information
Practice address
4802 S STATE ROUTE 159, GLEN CARBON, IL 62034-1904
(618) 288-4388
(618) 288-4927
Mailing address
1573 MALLORY LN STE 100, BRENTWOOD, TN 37027-2895
(615) 221-1400
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
—
—
Other
Enumeration date
05/20/2006
Last updated
07/07/2023
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