Organization
ORTHOPAEDIC SPECIALISTS OF SOUTH GEORGIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALESHA HERRING (PRACTICE MANAGER)
(912) 287-1130
Entity
Organization
Contact information
Practice address
501 W ONEIDA ST, WAYCROSS, GA 31501-5337
(912) 287-1130
(912) 287-1231
Mailing address
PO BOX 2267, WAYCROSS, GA 31502-2267
(912) 287-1130
(912) 287-1231
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
4309190001
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CH5524
PALMETTO GBA
GA
Enumeration date
08/31/2006
Last updated
02/18/2009
Update your record
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