Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Southern Orthopedic Associates SC

Organization Orthopaedic Surgery Physician · NPI 1396792412

Southern Orthopedic Associates SC is an Orthopaedic Surgery Physician in Herrin, Illinois. Licensed in Illinois and Kentucky. Registered with an NPI since 2006.

Licensed in
IL, KY
In the registry since
2006
Specialties on file
6

Practice location Address checks out

510 Lincoln Dr
Herrin, IL 62948-6334
Phone: (618) 997-6800
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Orthopaedic Surgery Physician (primary) Taxonomy 207X00000X · Licence 042617215 (IL)
Physical Therapist Taxonomy 225100000X
Occupational Therapist Taxonomy 225X00000X
Podiatric Clinic/Center Taxonomy 261QP1100X
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X · Licence 042617215 (KY)
Physician Assistant Taxonomy 363A00000X (KY)

Record details

NPI number1396792412
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official John Davis — President Orthopedic Surgeon · (618) 997-6800
NPI enumeratedMay 27, 2006
Last updated in NPPESOctober 4, 2022
Certification dateOctober 4, 2022
Mailing address510 Lincoln Drive, Herrin, IL 62948

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