Community Orthopedics & Sports Medicine, PC

NPI #1710261623 in Sparta, Illinois

Provider Information

NPI Number: 1710261623
Entity Type: Organization
Organization Name: Community Orthopedics & Sports Medicine, PC
Subpart: Yes (part of a larger organization)
Parent Organization: COMMUNITY ORTHOPEDICS & SPORTS MEDICINE, PC
Primary Specialty: Orthopaedic Surgery
Enumeration Date: Oct 11, 2011
Last Updated: Oct 11, 2011

Practice Location

Address: 818 E BROADWAY ST
Address 2: 1ST FLOOR
City: Sparta
State: Illinois
ZIP Code: 62286-1820
Phone: (618) 443-2177

Authorized Official

Name: MS. TAMMY ADDERLEY
Title: CREDENTIALING
Phone: (314) 432-2580

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Orthopaedic Surgery	207X00000X	Primary

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