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General NPI Number Information
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NPI Number | 1205690807
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Entity Type | Organization
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Legal Business Name | TALLAHASSEE ORTHOPEDIC CLINIC III, P.L.
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Dates
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Enumeration Date | 02/13/2024
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Last Update Date | 02/13/2024
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Provider Practice Location Address
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Address Line | 113 W HANSELL ST
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City | THOMASVILLE
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State | GA
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Zip | 31792-6664
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Country | US
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Telephone | 229-226-3060
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Fax | 855-460-8658
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Provider Business Mailing Address
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Address Line | 3334 CAPITAL MEDICAL BLVD STE 400
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City | TALLAHASSEE
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State | FL
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Zip | 32308-4470
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Country | US
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Telephone | 850-877-8174
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Fax | 844-261-6839
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | ALLISON POWELL
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Credential |
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Telephone | 850-877-8174
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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