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Organization

SOUTHLAKE ORTHOPAEDICS SPORTS MEDICINE AND SPINE CENTER, PC

Active
Other names
Southlake Orthopaedics
Organization subpart
No

Provider details

NPI number
Authorized official
DR. EKKEHARD BONATZ MD (PHYSICIAN)
(205) 985-4111
Entity
Organization

Contact information

Practice address
7191 CAHABA VALLEY RD, HOOVER, AL 35242-6443
(205) 985-4111
(205) 267-4411
Mailing address
4517 SOUTHLAKE PKWY, HOOVER, AL 35244-3280
(205) 985-4111

Taxonomy

Speciality
Code
Description
License number
State
207XS0106X
Orthopaedic Hand Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
529802230
AL
Enumeration date
06/04/2021
Last updated
02/10/2022
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