Organization
CLARK COUNTY ORTHOPEDIC GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JUDY A MOORE (INSURANCE CLERK)
(334) 636-0793
Entity
Organization
Contact information
Practice address
UNIT 134, 3050 HWY 5 N, THOMASVILLE, AL 36784-4325
(334) 636-0793
(334) 636-2280
Mailing address
UNIT 134, 3050 HWY 5 N, THOMASVILLE, AL 36784-4325
(334) 636-0793
(334) 636-2280
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
00003627
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K772
MEDICARE GROUP NUMBER
AL
Enumeration date
08/23/2006
Last updated
04/20/2008
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