Organization
SOUTHEAST JOINT REPLACEMENT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GRANT ZARZOUR MD (PRESIDENT)
(251) 654-3798
Entity
Organization
Contact information
Practice address
1720 SPRING HILL AVE FL 3, MOBILE, AL 36604-1410
(251) 435-2663
Mailing address
2304 DE LEON AVE, MOBILE, AL 36607-3212
(251) 654-3798
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1235424896
INDIVIDUAL
AL
Enumeration date
06/22/2023
Last updated
06/22/2023
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