Healthcare Provider Details

I. General information

NPI: 1467168047
Provider Name (Legal Business Name): SOUTHERN ORTHOCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2023
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2215 E LAMAR ALEXANDER PKWY
MARYVILLE TN
37804-5311
US

IV. Provider business mailing address

622 W 1ST NORTH ST
MORRISTOWN TN
37814-4544
US

V. Phone/Fax

Practice location:
  • Phone: 865-855-9701
  • Fax: 865-855-9702
Mailing address:
  • Phone: 423-307-1890
  • Fax: 423-307-1891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. JOSEPH T. HUNTSMAN JR.
Title or Position: OWNER
Credential:
Phone: 423-307-1890