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General NPI Number Information
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NPI Number | 1073314894
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Entity Type | Organization
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Legal Business Name | ORTHOPEDIC SURGICAL SERVICES, LLC
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Dates
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Enumeration Date | 03/19/2025
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Last Update Date | 03/19/2025
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Provider Practice Location Address
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Address Line | 1706 PROSPECT DR
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City | MACON
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State | MO
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Zip | 63552-2615
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Country | US
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Telephone | 660-385-1006
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Fax | 660-385-1028
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Provider Business Mailing Address
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Address Line | 1706 PROSPECT DR
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City | MACON
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State | MO
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Zip | 63552-2615
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Country | US
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Telephone | 660-385-1006
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Fax | 660-385-1028
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Authorized Official
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Title or Position | MEMBER
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Name | DONET CHRISTOPHER MAIN
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Credential | DO
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Telephone | 660-385-1006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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