Provider Demographics
NPI:1144092669
Name:SOUTHERN ORTHOPAEDIC ALLIANCE, PLLC
Entity type:Organization
Organization Name:SOUTHERN ORTHOPAEDIC ALLIANCE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:GRANT
Authorized Official - Last Name:ZARZOUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:251-654-3798
Mailing Address - Street 1:PO BOX 117709
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-7709
Mailing Address - Country:US
Mailing Address - Phone:253-236-4121
Mailing Address - Fax:
Practice Address - Street 1:731 LEIGHTON AVE STE 300
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-5762
Practice Address - Country:US
Practice Address - Phone:256-236-4121
Practice Address - Fax:256-237-5254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-27
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies