Provider Demographics
NPI:1538198700
Name:PRECISION ORTHOPEDICS PC
Entity type:Organization
Organization Name:PRECISION ORTHOPEDICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:ATHENS
Authorized Official - Suffix:JR
Authorized Official - Credentials:D O
Authorized Official - Phone:734-782-7003
Mailing Address - Street 1:25755 TELEGRAPH RD
Mailing Address - Street 2:
Mailing Address - City:BROWNSTOWN TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48134-1013
Mailing Address - Country:US
Mailing Address - Phone:734-782-7003
Mailing Address - Fax:734-782-7005
Practice Address - Street 1:25755 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:BROWNSTOWN TWP
Practice Address - State:MI
Practice Address - Zip Code:48134-1013
Practice Address - Country:US
Practice Address - Phone:734-782-7003
Practice Address - Fax:734-782-7005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101011454261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1396142287OtherIND NPI
2058214234OtherBCBS
MI4891150Medicaid
1982727756OtherIND NPI
1568433191OtherIND NPI
MI200H234470OtherBCBS GROUP PIN
MI1538198700OtherGROUP NPI
0P33780Medicare PIN
1568433191OtherIND NPI