NPI 1215025358

Weatherly Sports Medicine & Family Orthopaedics, PA

Organisation Orthopaedic Surgery Physician Jackson, MS

Practice location

Address: 1801 Crane Ridge Dr Suite C, Jackson, MS 39216-4902
Phone: (601) 981-5633
Fax: (601) 981-1844
Mailing address: PO Box 1154, Madison, MS 39130-1154

Authorised official

Name: Wallace W Weatherly
Title: Physician/Owner
Phone: (601) 856-5633

Registered specialties

Orthopaedic Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207X00000X

Other Orthopaedic Surgery providers in Mississippi →

Registry record

NPI: 1215025358
Entity type: Organization
NPI issued: 11 Oct 2006
Record last updated: 28 Mar 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.