SOUTH GA ORTHOPEDIC RESOURCES NPI 1295918712

NPI Information

NPI: 1295918712
Provider Name: SOUTH GA ORTHOPEDIC RESOURCES
Classification: Prosthetic/Orthotic Supplier - 335E00000X
Entity Type: Organization
Address: 1825 OLD OCILLA RD
TIFTON, GA
ZIP 31794
Phone: (229) 386-9829

NPI Details

SOUTH GA ORTHOPEDIC RESOURCES is a prosthetic orthotic supplier in Tifton, GA. The provider is an organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. SOUTH GA ORTHOPEDIC RESOURCES NPI is 1295918712. The provider is registered as an organization entity type.

The provider's business location address is:

1825 OLD OCILLA RD
TIFTON, GA
ZIP 31794-617
Phone: (229) 386-9829
Fax: (229) 386-9830

The provider's authorized official is Jeffery Dean Parson .
The authorized official title is Owner, Orthotist and has the following contact phone number (229) 386-9829.

The enumeration date for this NPI number is 12/6/2007 and was last updated on 7/31/2023.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	335E00000X	Prosthetic/Orthotic Supplier				Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	057062934A	MEDICAID	GEORGIA

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: 6/30/2024

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