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CAPITAL ORTHOPAEDIC CLINIC PLLC NPI 1770687881


NPI Information

NPI: 1770687881
Provider Name: CAPITAL ORTHOPAEDIC CLINIC, PLLC

Doing Business As: CAPITAL ORTHOPAEDIC & SPORTS MEDICINE CENTER

Classification: Orthopaedic Surgery - 207X00000X
Entity Type: Organization

CLIA Number: 25D1035706

Address:
104 BURNEY DR
FLOWOOD, MS
ZIP 39232
Phone: (601) 987-8200
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CAPITAL ORTHOPAEDIC CLINIC, PLLC is an orthopaedic surgery in Flowood, MS. The provider is an orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. CAPITAL ORTHOPAEDIC CLINIC, PLLC NPI is 1770687881. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Capital Orthopaedic & Sports Medicine Center.

The provider's business location address is:

104 BURNEY DR
FLOWOOD, MS
ZIP 39232-621
Phone: (601) 987-8200
Fax: (601) 987-8211

The provider's authorized official is Michael G Dulske .
The authorized official title is Managing Owner and has the following contact phone number (601) 987-8200.

The CLIA number assigned to this NPI record is 25D1035706 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/11/2006 and was last updated on 10/16/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207X00000XOrthopaedic Surgery13058MISSISSIPPIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
109012262MEDICAIDMISSISSIPPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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