Organization
AMG-HILLSIDE LLC
Active
Other names
Giles County Orthopaedic and Joint Center
Organization subpart
No
Provider details
NPI number
Authorized official
JONE KOFORD (DIVISION PRESIDENT)
(615) 372-8503
Entity
Organization
Contact information
Practice address
204 HILLSIDE DRIVE, PULASKI, TN 38478
(931) 363-3514
(931) 363-3595
Mailing address
PO BOX 621, PULASKI, TN 38478-0621
(931) 363-3514
(931) 363-3595
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3153524
BCBS TN
TN
01
—
CK2947
RAILROAD MEDICARE
—
Enumeration date
04/20/2007
Last updated
04/15/2010
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