# SOUTHLAKE ORTHOPAEDICS SPORTS MEDICINE AND SPINE CENTER, PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Southlake Orthopaedics
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639746050
- **Authorized official:** DR. EKKEHARD BONATZ MD (PHYSICIAN)
- **Authorized official phone:** (205) 985-4111

## Contact information

- **Practice address:** 7191 CAHABA VALLEY RD, HOOVER, AL 35242-6443
- **Practice address phone:** (205) 985-4111
- **Practice address fax:** (205) 267-4411
- **Mailing address:** 4517 SOUTHLAKE PKWY, HOOVER, AL 35244-3280
- **Mailing address phone:** (205) 985-4111

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207XS0106X | Orthopaedic Hand Surgery Physician | — | NULL | Yes |
| 207XS0106X | Orthopaedic Hand Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/04/2021
- **Last updated:** 02/10/2022