Healthcare Provider Details

I. General information

NPI: 1154177947
Provider Name (Legal Business Name): SOUTHERN ORTHOPAEDIC ALLIANCE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2024
Last Update Date: 04/24/2024
Certification Date: 04/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

831 HILLCREST RD STE C
MOBILE AL
36695-4075
US

IV. Provider business mailing address

PO BOX 117709
ATLANTA GA
30368-7709
US

V. Phone/Fax

Practice location:
  • Phone: 251-435-2663
  • Fax: 251-435-1098
Mailing address:
  • Phone: 251-435-2663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH GRANT ZARZOUR
Title or Position: PRINCIPLE PHYSICIAN
Credential: MD
Phone: 251-654-3798