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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