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SOUTHEAST ORTHOPEDIC SPECIALISTS LLC NPI 1629025820


NPI Information

NPI: 1629025820
Provider Name: SOUTHEAST ORTHOPEDIC SPECIALISTS, LLC

Former Legal Business Name: R DAVID HEEKIN, MD, PA

Classification: Orthopaedic Surgery - 207XX0801X
Entity Type: Organization

Specialization: Orthopaedic Trauma

Address:
2627 RIVERSIDE AVE
3RD FLOOR
JACKSONVILLE, FL
ZIP 32204
Phone: (904) 634-0640
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SOUTHEAST ORTHOPEDIC SPECIALISTS, LLC is an orthopaedic trauma orthopaedic surgery in Jacksonville, FL. The provider is recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic trauma surgeons deal with the evaluation and management of acute orthopaedic injuries, evaluation and treatment of post-traumatic deformities and nonunions, acute and delayed reconstruction of pelvic and acetabular fractures, as well as osteotomy in the adult hip for treatment of hip arthritis. SOUTHEAST ORTHOPEDIC SPECIALISTS, LLC NPI is 1629025820. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is R David Heekin, Md, Pa.

The provider's business location address is:

2627 RIVERSIDE AVE
3RD FLOOR
JACKSONVILLE, FL
ZIP 32204-712
Phone: (904) 634-0640
Fax: (904) 634-0203

The provider's authorized official is Brett Puckett .
The authorized official title is Ceo and has the following contact phone number (904) 634-0640.

The enumeration date for this NPI number is 5/31/2006 and was last updated on 12/12/2022.


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
1174400000XSpecialistNo
2207QS0010XFamily MedicineSports MedicineNo
3207X00000XOrthopaedic SurgeryNo
4207XS0106XOrthopaedic SurgeryHand SurgeryNo
5207XS0114XOrthopaedic SurgeryAdult Reconstructive Orthopaedic SurgeryNo
6207XX0004XOrthopaedic SurgeryFoot and Ankle SurgeryNo
7207XX0005XOrthopaedic SurgerySports MedicineNo
8208VP0000XPain MedicinePain MedicineNo
9208VP0014XPain MedicineInterventional Pain MedicineNo
10213E00000XPodiatristNo
11207XX0801XOrthopaedic SurgeryOrthopaedic TraumaYes

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: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.