Provider Demographics
NPI:1174792279
Name:ORTHOPAEDIC GROUP OF THE SOUTHEAST LLC
Entity type:Organization
Organization Name:ORTHOPAEDIC GROUP OF THE SOUTHEAST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:SORRELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-822-9595
Mailing Address - Street 1:200 MONTGOMERY HWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35216-1842
Mailing Address - Country:US
Mailing Address - Phone:205-822-9595
Mailing Address - Fax:
Practice Address - Street 1:200 MONTGOMERY HWY
Practice Address - Street 2:SUITE 200
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35216-1842
Practice Address - Country:US
Practice Address - Phone:205-822-9595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-22
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty