Healthcare Provider Details

I. General information

NPI: 1134563042
Provider Name (Legal Business Name): HOUSTON ORTHOPEDIC SURGERY & SPORTS MEDICINE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2013
Last Update Date: 02/20/2025
Certification Date: 02/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1013 MAIN ST
PERRY GA
31069-3353
US

IV. Provider business mailing address

3051 WATSON BLVD STE 525
WARNER ROBINS GA
31093-8556
US

V. Phone/Fax

Practice location:
  • Phone: 478-953-4563
  • Fax:
Mailing address:
  • Phone: 478-953-4563
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DR. KEATHERN SCOTT MALONE
Title or Position: MD
Credential: MD
Phone: 478-953-4563