OrganizationActive
Southern Orthopedic Associates, S.c.
NPI 1104075126 · Orthopaedic Surgery Physician · Carrondale, IL
Provider details
- NPI number
- 1104075126
- Entity type
- Organization
- Primary specialty
- Orthopaedic Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Thomas Davis, President/Orthopedic Surgeon(618) 997-6800
- License
- 042617215 (IL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(86/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1101 Diann Lane
Carrondale, IL 62901
Phone: (618) 997-6800
Fax: (618) 457-0211
Street-level locationGet directions
Mailing address
510 Lincoln Drive
Herrin, IL 62948
Registry dates
- Enumerated
- 2008-09-15
- Last updated
- 2008-09-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.