Provider Demographics
NPI:1326579582
Name:SOUTHERN ORTHOPAEDIC SURGEONS, LLC
Entity Type:Organization
Organization Name:SOUTHERN ORTHOPAEDIC SURGEONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROLAND
Authorized Official - Middle Name:A
Authorized Official - Last Name:HESTER
Authorized Official - Suffix:IV
Authorized Official - Credentials:MD
Authorized Official - Phone:334-613-9000
Mailing Address - Street 1:454 TAYLOR RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-3563
Mailing Address - Country:US
Mailing Address - Phone:334-613-9000
Mailing Address - Fax:334-532-0057
Practice Address - Street 1:9 CAMBRIDGE CT
Practice Address - Street 2:
Practice Address - City:WETUMPKA
Practice Address - State:AL
Practice Address - Zip Code:36093-1261
Practice Address - Country:US
Practice Address - Phone:334-613-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-21
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies