Organization
SOUTHERN CENTER FOR ORTHOPEDICS
Active
Other names
Southern Orthopedics Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GLORIA W KELLEY (EXECUTIVE SECRETARY)
(706) 884-2691
Entity
Organization
Contact information
Practice address
1805 VERNON RD, SUITE B, LAGRANGE, GA 30240-4041
(706) 884-2691
(706) 845-7314
Mailing address
1805 VERNON RD, SUITE B, LAGRANGE, GA 30240-4041
(706) 884-2691
(706) 845-7314
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
23336
GA
Other
Enumeration date
02/09/2007
Last updated
08/22/2020
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