SPARTAN ORTHOPAEDICS LLC NPI 1619346111

NPI Information

  • NPI: 1619346111
  • Provider Name: SPARTAN ORTHOPAEDICS, LLC
  • Classification: Orthopaedic Surgery - 207X00000X
  • Entity Type: Organization
  • :
  • Address: 6518 GOODMAN RD STE 104
    OLIVE BRANCH, MS
    ZIP 38654
  • Phone: (662) 420-7350

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NPI Details

SPARTAN ORTHOPAEDICS, LLC is an orthopaedic surgery in Olive Branch, 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. SPARTAN ORTHOPAEDICS, LLC NPI is 1619346111. The provider is registered as an organization entity type and is a multi-specialty group.
The provider .

The provider's business location address is:

6518 GOODMAN RD STE 104
OLIVE BRANCH, MS
ZIP 38654-809
Phone: (662) 420-7350
Fax: (662) 874-5214

The provider's authorized official is Jennifer C Bullock .
The authorized official title is President and has the following contact phone number (662) 534-2298.

The enumeration date for this NPI number is 9/15/2015 and was last updated on 9/2/2025.

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
1363L00000XNurse PractitionerNo
2207X00000XOrthopaedic SurgeryYes

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
16131110004OTHERMISSISSIPPIMEDICARE DME PTAN
202654844MEDICAIDMISSISSIPPI
3512G700048OTHERMISSISSIPPIMEDICARE PTAN

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: 11/21/2025

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