Organization Name: | SOUTHERN ORTHOPEDIC ASSOCIATES, S.C. |
NPI Number: | 1740598390 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | THOMAS WEST DAVIS (PRESIDENT) |
Mailing Address: | 3530 Lone Oak Rd Suite A Paducah |
State: | KY US |
Postal Code: | 420035752 |
Phone Number: | 2705540505 |
Fax Number: | 2705540905 |
NPI Enumeration Date: | 09/16/2010 |
NPI Last Update Date: | 09/30/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 042617215 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |