Organization
SOUTHEAST ORTHOPEDIC SPECIALISTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRETT CHRISTOPHER PUCKETT MD (PRESIDENT)
(904) 634-0640
Entity
Organization
Contact information
Practice address
2 SHIRCLIFF WAY STE 605, JACKSONVILLE, FL 32204-4762
(904) 634-0640
(904) 634-0203
Mailing address
6800 SOUTHPOINT PKWY STE 300, JACKSONVILLE, FL 32216-8203
(904) 634-0640
(904) 634-0203
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
Other
Enumeration date
09/24/2020
Last updated
12/12/2022
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