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SOUTHEASTERN ORTHOTICS & PROSTHETICS INC NPI 1679572655


NPI Information

NPI: 1679572655
Provider Name: SOUTHEASTERN ORTHOTICS & PROSTHETICS, INC

Doing Business As: SOUTHEASTERN ORTHOTICS & PROSTHETICS, INC

Classification: Prosthetic/Orthotic Supplier - 335E00000X
Entity Type: Organization

CLIA Number: 44D2053806

Address:
316 N HOLTZCLAW AVE
CHATTANOOGA, TN
ZIP 37404
Phone: (423) 698-0184
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SOUTHEASTERN ORTHOTICS & PROSTHETICS, INC is a prosthetic orthotic supplier in Chattanooga, TN. 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. SOUTHEASTERN ORTHOTICS & PROSTHETICS, INC NPI is 1679572655. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Southeastern Orthotics & Prosthetics, Inc.

The provider's business location address is:

316 N HOLTZCLAW AVE
CHATTANOOGA, TN
ZIP 37404-305
Phone: (423) 698-0184
Fax: (423) 698-0568

The provider's authorized official is Lauren Vaughn .
The authorized official title is Vp Of Operations and has the following contact phone number (615) 890-2160.

The CLIA number assigned to this NPI record is 44D2053806 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/20/2005 and was last updated on 1/18/2022.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1224P00000XProsthetistNo
2335E00000XProsthetic/Orthotic SupplierTENNESSEEYes

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: 11/14/2023

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.