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General NPI Number Information
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NPI Number | 1669266599
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Entity Type | Organization
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Legal Business Name | SOUTHERN ORTHOPAEDIC SURGEONS, LLC
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Dates
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Enumeration Date | 04/07/2025
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Last Update Date | 04/07/2025
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Provider Practice Location Address
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Address Line | 1470 TAYLOR RD STE 109
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City | MONTGOMERY
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State | AL
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Zip | 36117-3747
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Country | US
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Telephone | 334-613-9000
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Fax | 334-532-0056
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Provider Business Mailing Address
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Address Line | 454 TAYLOR RD
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City | MONTGOMERY
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State | AL
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Zip | 36117-3563
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Country | US
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Telephone | 334-613-9000
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Fax | 334-532-0056
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | ROLAND A HESTER
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Credential |
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Telephone | 334-613-9000
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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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