MEDICARE: SOUTHERN ORTHOCARE, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	335E00000X	Prosthetic/Orthotic Supplier

General Provider Information

NPI Number	:	1841834322
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHERN ORTHOCARE, INC

Provider Business Mailing Address
First Line	:	622 W 1ST NORTH ST
Second Line	:
City	:	MORRISTOWN
State	:	TN
Zip	:	37814-4544
Country	:	US
Telephone Number	:	423-307-1890
Fax Number	:	423-307-1891

Provider Business Practice Location Address
First Line	:	10241 KINGSTON PIKE STE 4
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37922-3240
Country	:	US
Telephone Number	:	865-672-6740
Fax Number	:	865-672-6741

Authorized Official
Title or Position	:	CEO
Name	:	JOSEPH HUNTSMAN JR.
Credential	:
Telephone Number	:	423-307-1890

Provider Enumeration Date	:	10/29/2019
Last Update Date	:	06/17/2026

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Directions to “SOUTHERN ORTHOCARE, INC ” Practice Location

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