Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Weatherly Sports Medicine & Family Orthopaedics, PA

Organization Orthopaedic Surgery Physician · NPI 1215025358

Weatherly Sports Medicine & Family Orthopaedics, PA is an Orthopaedic Surgery Physician in Jackson, Mississippi. Registered with an NPI since 2006.

In the registry since
2006
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1801 Crane Ridge Dr Ste C
Jackson, MS 39216-4902
Phone: (601) 981-5633
Fax: (601) 981-1844
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Orthopaedic Surgery Physician (primary) Taxonomy 207X00000X

Record details

NPI number1215025358
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Wallace Weatherly — Physician/Owner · (601) 856-5633
NPI enumeratedOctober 11, 2006
Last updated in NPPESMarch 28, 2014
Mailing addressPo Box 1154, Madison, MS 39130-1154

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