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Contact Information

SOUTHEASTERN ORTHOPEDICS
110 SHIRLEY AVENUE
DOUGLAS, GA31533
 Phone: 912-383-9789
 Fax: 912-383-9435
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Orthopaedic Surgery

207X00000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for SOUTHEASTERN ORTHOPEDICS · (Female)

NPI Number 1184053043
Status Active
Credentials
Entity Individual
Enumeration date 11/01/2013
Last updated 11/01/2013 - About 13 years ago
Sole proprietor 1 Not specified
Identifiers
  • GA License # 045391
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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