Southern Orthopedic Associates Sc

NPI #1396792412 in Herrin, Illinois

Provider Information

NPI Number: 1396792412
Entity Type: Organization
Organization Name: Southern Orthopedic Associates Sc
Primary Specialty: Orthopaedic Surgery
Enumeration Date: May 27, 2006
Last Updated: Oct 4, 2022

Practice Location

Address: 510 LINCOLN DR
City: Herrin
State: Illinois
ZIP Code: 62948-6334
Phone: (618) 997-6800

Authorized Official

Name: DR. JOHN DAVIS, MD
Title: PRESIDENT ORTHOPEDIC SURGEON
Phone: (618) 997-6800

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X
Occupational Therapist	225X00000X
Clinic/Center - Podiatric — Podiatric	261QP1100X
Durable Medical Equipment & Medical Supplies	332B00000X
Physician Assistant	363A00000X
Orthopaedic Surgery	207X00000X	Primary

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