Organization
PREMIER ORTHOPAEDICS & SPORTS MEDICINE, PLC
Active
Other names
Hughston Clinic Orthopaedics
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA GRACE FROMKIN (DIRECTOR OF CREDENTIALING)
(706) 494-3071
Entity
Organization
Contact information
Practice address
5651 FRIST BLVD STE 711, HERMITAGE, TN 37076-2061
(615) 889-3349
(615) 889-6087
Mailing address
PO BOX 370, FORTSON, GA 31808-0370
(706) 494-3071
(706) 494-3008
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3707844
—
TN
Enumeration date
11/01/2006
Last updated
04/28/2019
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