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Organization

SOUTHERN SPINE & ORTHOPAEDICS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KATHRYN CLARK (CREDENTIALING)
(337) 706-1142
Entity
Organization

Contact information

Practice address
105 PATRIOT ST STE 101, LAFAYETTE, LA 70508-6831
(337) 981-2125
(337) 981-2174
Mailing address
105 PATRIOT ST STE 101, LAFAYETTE, LA 70508-6831
(337) 981-2125
(337) 981-2174

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary

Other

Enumeration date
09/16/2024
Last updated
09/16/2024
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