Organization
SOUTHERN ORTHOPEDIC ASSOCIATES, S.C.
Active
Organization
SOUTHERN ORTHOPEDIC ASSOCIATES, S.C.
Active
Other names
Orthopedic Institute of Western Kentucky
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS WEST DAVIS (PRESIDENT)
(618) 997-6800
Entity
Organization
Contact information
Practice address
3530 LONE OAK RD, SUITE A, PADUCAH, KY 42003-5752
(270) 554-0505
(270) 554-0905
Mailing address
510 LINCOLN DR, HERRIN, IL 62948-6334
(618) 997-6800
(618) 998-9124
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
042.617215
IL
332B00000X
Durable Medical Equipment & Medical Supplies
042617215
IL
Other
Enumeration date
09/16/2010
Last updated
09/30/2010
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