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General NPI Number Information
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NPI Number | 1467168047
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Entity Type | Organization
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Legal Business Name | SOUTHERN ORTHOCARE INC
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Dates
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Enumeration Date | 01/26/2023
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Last Update Date | 04/28/2025
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Provider Practice Location Address
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Address Line | 2022 CHILHOWEE MEDICAL PARK
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City | MARYVILLE
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State | TN
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Zip | 37804-5285
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Country | US
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Telephone | 865-855-9701
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Fax | 865-855-9702
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Provider Business Mailing Address
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Address Line | 622 W 1ST NORTH ST
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City | MORRISTOWN
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State | TN
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Zip | 37814-4544
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Country | US
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Telephone | 423-307-1890
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Fax | 423-453-5354
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Authorized Official
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Title or Position | OWNER
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Name | MR. JOSEPH T. HUNTSMAN JR.
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Credential |
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Telephone | 423-307-1890
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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