Mid State Orthopaedic & Sports Medicine Center LLC

NPI #1609320506 in Jena, Louisiana

Provider Information

NPI Number: 1609320506
Entity Type: Organization
Organization Name: Mid State Orthopaedic & Sports Medicine Center LLC
Subpart: Yes (part of a larger organization)
Parent Organization: MID STATE ORTHOPAEDIC & SPORTS MEDICINE CENTER LLC
Primary Specialty: Orthopaedic Surgery
Enumeration Date: Aug 9, 2016
Last Updated: Apr 26, 2021

Practice Location

Address: 155 NINTH ST
Address 2: STE A
City: Jena
State: Louisiana
ZIP Code: 71342-3900
Phone: (318) 473-9556

Authorized Official

Name: MARK A DODSON, M.D.
Title: PRESIDENT
Phone: (318) 473-9556

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Medicine & Rehabilitation	208100000X
Orthopaedic Surgery	207X00000X	Primary

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