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General NPI Number Information
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NPI Number | 1437185444
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Entity Type | Organization
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Legal Business Name | SANDHILL BONE & JOINT INC
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Dates
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Enumeration Date | 06/23/2006
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Last Update Date | 09/15/2008
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Provider Practice Location Address
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Address Line | 511 W ALEXANDER ST
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City | PLANT CITY
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State | FL
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Zip | 33563
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Country | US
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Telephone | 813-754-0817
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Fax | 813-707-1977
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Provider Business Mailing Address
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Address Line | P.O. BOX 2065
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City | PLANT CITY
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State | FL
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Zip | 33564
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Country | US
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Telephone | 813-754-0817
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Fax | 813-707-1977
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Authorized Official
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Title or Position | OWNER
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Name | DR. SUSAN M OTT
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Credential | DO
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Telephone | 813-754-0817
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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 | OS8868
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License Number State | FL
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