Weatherly Sports Medicine & Family Orthopaedics, Pa
LBN: Weatherly Sports Medicine & Family Orthopaedics, Pa
Weatherly Sports Medicine & Family Orthopaedics, Pa is an health care organization with primary practice located at 1801 Crane Ridge Dr Suite C, Jackson MS 39216-4902. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as the primary health care specialty.
Weatherly Sports Medicine & Family Orthopaedics, Pa can be contacted via phone (601) 981-5633, or through Weatherly, Wallace W via phone (601) 856-5633.
Contact Information
Primary practice address
1801 Crane Ridge Dr Suite C
Jackson MS 39216-4902
Phone: (601) 981-5633
Fax: (601) 981-1844
Website:
Authorized official contact:
Name: Weatherly, Wallace W Doctor of Medicine (MD)
Phone: (601) 856-5633
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X |
Profile Details
| NPI number | 1215025358 |
|---|---|
| LBN Legal business name | Weatherly Sports Medicine & Family Orthopaedics, Pa |
| DBA Doing business as | |
| Authorized official | Weatherly, Wallace W Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Oct 11th, 2006 |
| Last updated | Mar 28th, 2014 - about 10 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215025358 | NPPES |
| Mississippi | MEDICAID | 07105081 |
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