Southern Orthopedic Associates, S.c.

NPI #1104075126 in Carrondale, Illinois

Provider Information

NPI Number: 1104075126
Entity Type: Organization
Organization Name: Southern Orthopedic Associates, S.c.
Primary Specialty: Orthopaedic Surgery
Enumeration Date: Sep 15, 2008
Last Updated: Sep 15, 2008

Practice Location

Address: 1101 DIANN LANE
City: Carrondale
State: Illinois
ZIP Code: 62901
Phone: (618) 997-6800

Authorized Official

Name: DR. THOMAS WEST DAVIS
Title: PRESIDENT/ORTHOPEDIC SURGEON
Phone: (618) 997-6800

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Orthopaedic Surgery	207X00000X	Primary

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