Provider Demographics
NPI:1326006016
Name:THE ORTHOPAEDIC AND SPORTS MEDICINE CENTER OF CAMDEN, P.C.
Entity Type:Organization
Organization Name:THE ORTHOPAEDIC AND SPORTS MEDICINE CENTER OF CAMDEN, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:A
Authorized Official - Last Name:FELIX
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:912-729-8123
Mailing Address - Street 1:64 ANDREWS WAY
Mailing Address - Street 2:
Mailing Address - City:KINGSLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31548-6832
Mailing Address - Country:US
Mailing Address - Phone:912-729-8123
Mailing Address - Fax:912-729-8133
Practice Address - Street 1:64 ANDREWS WAY
Practice Address - Street 2:
Practice Address - City:KINGSLAND
Practice Address - State:GA
Practice Address - Zip Code:31548-6832
Practice Address - Country:US
Practice Address - Phone:912-729-8123
Practice Address - Fax:912-729-8133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-02
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK9850Medicare ID - Type Unspecified
GAGRP6667Medicare ID - Type Unspecified