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Contact Information

SOUTHERN ORTHOPEDICS AND SPORTS MEDICINE, LLC
851 LEONARD FULGHUM BLVD
SUITE 101
MOUNT PLEASANT, SC29464-3787
 Phone: 843-971-9350
 Fax: 843-971-9351
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Orthopaedic Surgery

207X00000X 02 Physician/General Surgery
 

Sports Medicine

207PS0010X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for SOUTHERN ORTHOPEDICS AND SPORTS MEDICINE, LLC

NPI Number 1053568428
LBN Legal business name SOUTHERN ORTHOPEDICS AND SPORTS MEDICINE, LLC
Authorized official MICHAEL BURTNETT - (SVP OF OUTPATIENT SERVICES, TENET)
Entity Organization
Organization subpart 1 No
Enumeration date 08/27/2008
Last updated 06/23/2016 - About 10 years ago
Identifiers
SC Medicaid GP5001
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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