Provider Demographics
NPI:1164489951
Name:THE ORTHOPAEDIC GROUP, PC
Entity Type:Organization
Organization Name:THE ORTHOPAEDIC GROUP, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:PAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-476-5050
Mailing Address - Street 1:PO BOX 86144
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36689-6144
Mailing Address - Country:US
Mailing Address - Phone:251-476-5050
Mailing Address - Fax:251-450-2770
Practice Address - Street 1:6144 AIRPORT BLVD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-3143
Practice Address - Country:US
Practice Address - Phone:251-476-5050
Practice Address - Fax:251-450-2770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-27
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALCD9595OtherRAILROAD MEDICARE
ALJ378OtherMEDICARE ID
AL529800210Medicaid
MS09014669Medicaid
361721600OtherUS DEPARTMENT OF LABOR
MS09014669Medicaid
361721600OtherUS DEPARTMENT OF LABOR
ALCD9595OtherRAILROAD MEDICARE
1211590004Medicare NSC