Healthcare Provider Details

I. General information

NPI: 1720163512
Provider Name (Legal Business Name): ORTHOPARTNERS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 01/03/2022
Certification Date: 01/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15301 SPECTRUM DR SUITE 175
ADDISON TX
75001-4665
US

IV. Provider business mailing address

2534 EMPIRE DR
WINSTON SALEM NC
27103-6710
US

V. Phone/Fax

Practice location:
  • Phone: 972-980-9660
  • Fax: 972-980-9313
Mailing address:
  • Phone: 336-397-2165
  • Fax: 336-397-2167

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number101332
License Number StateTX

VIII. Authorized Official

Name: JANET WOODALL
Title or Position: DIRECTOR OF CONTRACTING
Credential:
Phone: 336-397-0993