Provider Demographics
NPI:1750480323
Name:PRINCETON ORTHOPAEDICS, P.C.
Entity type:Organization
Organization Name:PRINCETON ORTHOPAEDICS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THEODIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BUGGS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:205-783-7830
Mailing Address - Street 1:817 PRINCETON AVE SW
Mailing Address - Street 2:POB II, SUITE 108
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35211-1333
Mailing Address - Country:US
Mailing Address - Phone:205-783-7830
Mailing Address - Fax:205-783-7832
Practice Address - Street 1:817 PRINCETON AVE SW
Practice Address - Street 2:POB II, SUITE 108
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35211-1333
Practice Address - Country:US
Practice Address - Phone:205-783-7830
Practice Address - Fax:205-783-7832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK00009766207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51521019OtherBLUE CROSS BLUE SHIELD
AL51521019OtherBLUE CROSS BLUE SHIELD