Southeast Orthopedic Specialists, Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

SOUTHEAST ORTHOPEDIC SPECIALISTS, INC.

Practice address

1658 St Vincents Way Ste 100
Middleburg, FL 32068-8447

Phone

(904) 634-0640

Fax

(904) 634-0203

NPI assigned

Dec 26, 2013

Last updated

Dec 30, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gavan R Duffy, MD

Title

President / Ceo

Phone

(904) 634-0640

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1388016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451433600000",
    "number": "1730500497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 BOWDEN RD",
            "address_2": "SUITE 103",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168070",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1658 ST VINCENTS WAY STE 100",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320688447",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST ORTHOPEDIC SPECIALISTS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-26",
        "last_updated": "2015-12-30",
        "status": "A",
        "authorized_official_last_name": "DUFFY",
        "authorized_official_first_name": "GAVAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT / CEO",
        "authorized_official_telephone_number": "904-634-0640",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra Warren Smothers
• Ibet Socarras, RBT
• Solantic of Jacksonville, LLC (CareSpot-Middleburg)
• Monika Sood, PA-C
• South Clay Medical Associates Inc
• Specialized Patient Transport LLC (medex)
• William David Speer, PA-C
• Kelly Ann Sprague
• Thomas Spratley
• St. Vincent's Medical Center - Clay County, Inc (St. Vincent's Clay County - Cardiology)

• Specialist in Middleburg, FL
• Providers in Middleburg, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.