Provider Demographics
NPI:1790875763
Name:AMERICAN SPORTS MEDICINE INSTITUTE
Entity Type:Organization
Organization Name:AMERICAN SPORTS MEDICINE INSTITUTE
Other - Org Name:ASMI
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCWHORTER
Authorized Official - Suffix:
Authorized Official - Credentials:MLS
Authorized Official - Phone:205-918-2135
Mailing Address - Street 1:2660 10TH AVE S
Mailing Address - Street 2:SUITE 505
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-1605
Mailing Address - Country:US
Mailing Address - Phone:205-918-0000
Mailing Address - Fax:205-918-2177
Practice Address - Street 1:2660 10TH AVE S
Practice Address - Street 2:SUITE 505
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-1605
Practice Address - Country:US
Practice Address - Phone:205-918-0000
Practice Address - Fax:205-918-2177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-25052OtherBCBS AL PROVIDER NUMBER