Provider Demographics
NPI:1124201355
Name:ORTHOPEDIC SPECIALISTS, LLC
Entity Type:Organization
Organization Name:ORTHOPEDIC SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MISTY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BUCHANAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-781-9077
Mailing Address - Street 1:98 CLEARWATER DR
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-1331
Mailing Address - Country:US
Mailing Address - Phone:207-781-9077
Mailing Address - Fax:207-347-8285
Practice Address - Street 1:98 CLEARWATER DR
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-1331
Practice Address - Country:US
Practice Address - Phone:207-781-9077
Practice Address - Fax:207-347-8285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-11
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty