Organization
SOUTHEASTERN ORTHOPAEDIC SPECIALISTS
Active
Parent organization
SOUTHEASTERN ORTHOPAEDIC SPECIALISTS
Other names
Sports Medicine and Orthopaedic Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHEASTERN ORTHOPAEDIC SPECIALISTS
Authorized official
DR. RODNEY A. MORTENSON M.D. (SENIOR PARTNER)
(336) 275-6318
Entity
Organization
Contact information
Practice address
209 LINDSAY ST, SUITE 204, HIGH POINT, NC 27262-4853
(336) 887-8400
(336) 887-3013
Mailing address
209 LINDSAY ST, SUITE 204, HIGH POINT, NC 27262-4853
(336) 887-8400
(336) 887-3013
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1190220002
DME LOCATION PROVIDER NUM
NC
Enumeration date
10/25/2007
Last updated
10/25/2007
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