Provider Demographics
NPI:1326357138
Name:PREMIER ORTHOPEDICS, PC
Entity Type:Organization
Organization Name:PREMIER ORTHOPEDICS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BENNETT
Authorized Official - Middle Name:D
Authorized Official - Last Name:COTTEN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:229-435-1458
Mailing Address - Street 1:PO BOX 70969
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31708-0969
Mailing Address - Country:US
Mailing Address - Phone:229-435-1458
Mailing Address - Fax:229-317-2342
Practice Address - Street 1:1107 GREER ST
Practice Address - Street 2:
Practice Address - City:CORDELE
Practice Address - State:GA
Practice Address - Zip Code:31015-1920
Practice Address - Country:US
Practice Address - Phone:229-273-6025
Practice Address - Fax:229-317-2342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-28
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty