Provider Demographics
NPI:1467865758
Name:TUSCALOOSA ORTHOPEDIC & JOINT INSTITUTE, LLC
Entity Type:Organization
Organization Name:TUSCALOOSA ORTHOPEDIC & JOINT INSTITUTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-391-4440
Mailing Address - Street 1:100 RICE MINE ROAD LOOP STE 205
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35406-2419
Mailing Address - Country:US
Mailing Address - Phone:205-391-4440
Mailing Address - Fax:205-391-4441
Practice Address - Street 1:100 RICE MINE ROAD LOOP STE 205
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35406-2419
Practice Address - Country:US
Practice Address - Phone:205-391-4440
Practice Address - Fax:205-391-4441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-04
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic SurgeryGroup - Single Specialty