Organization
SOUTH GA ORTHOPEDIC RESOURCES INC
Active
Other names
Georgia Orthopedic Resources
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAKE ERIC BENTLEY L.O.,C.O. (MANAGER/PART OWNER)
(678) 960-4424
Entity
Organization
Contact information
Practice address
590 S ENOTA DR NE STE 1B, GAINESVILLE, GA 30501-2433
(678) 960-4424
(678) 680-7903
Mailing address
1825 OLD OCILLA RD, TIFTON, GA 31794-1617
(229) 386-9829
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
L.O. 14
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
057062934C
—
GA
Enumeration date
04/28/2014
Last updated
01/20/2026
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