Organization
ORTHOPEDICS SPORTS MEDICINE & SURGERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CAROL L HOPPER M.ED., RRT (DIRECTOR PHYSICIAN SEVICES)
(706) 647-3035
Entity
Organization
Contact information
Practice address
612 W GORDON ST, SUITE E, THOMASTON, GA 30286-3480
(706) 647-3030
(706) 647-3033
Mailing address
PO BOX 589, 801 WEST GORDON ST, THOMASTON, GA 30286-0008
(706) 647-8111
(706) 647-4389
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003121667A
BOYCE MCD TH
GA
01
—
003121667B
BOYCE MCD BV
GA
05
—
003122757A
—
GA
Enumeration date
03/18/2010
Last updated
07/30/2012
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