Organization
SOUTHERN ORTHOPEDIC ASSOCIATES, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS WEST DAVIS (PRESIDENT/ORTHOPEDIC SURGEON)
(618) 997-6800
Entity
Organization
Contact information
Practice address
1101 DIANN LANE, CARRONDALE, IL 62901
(618) 997-6800
(618) 457-0211
Mailing address
510 LINCOLN DRIVE, HERRIN, IL 62948
(618) 997-6800
(618) 457-0211
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
042617215
IL
Other
Enumeration date
09/15/2008
Last updated
09/15/2008
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