Healthcare Provider Details

I. General information

NPI: 1619013422
Provider Name (Legal Business Name): SHOALS ORTHOPEDICS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 07/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

426 W COLLEGE ST
FLORENCE AL
35630-5521
US

IV. Provider business mailing address

426 W COLLEGE ST
FLORENCE AL
35630-5521
US

V. Phone/Fax

Practice location:
  • Phone: 256-718-4041
  • Fax: 256-718-3665
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: KERRY DEL PIZZO
Title or Position: OFFICE MANAGER
Credential:
Phone: 256-718-4041