Organization · Type 2 NPI

South Ga Orthopedic Resources Inc

Prosthetic/Orthotic Supplier · Gainesville, GA

NPI number 1780094987 Active

Practice location

590 S Enota Dr NE Ste 1B
Gainesville, GA 30501-2433

Call (678) 960-4424 Map

Fax (678) 680-7903

Mailing address

1825 Old Ocilla Rd
Tifton, GA 31794-1617

Specialties and licenses

Taxonomy	Code	License
Prosthetic/Orthotic Supplier Primary	335E00000X	L.O. 14 (GA)

Prosthetic/Orthotic Supplier: An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.

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NPI record

NPI: 1780094987
Entity type: Organization (Type 2)
Issued: Apr 28, 2014
Last updated: Jan 20, 2026
Status: Active

Other names

<unavail>
Georgia Orthopedic Resources · doing business as
Georgia Orthopedic Resources · doing business as

Authorized official

Mr. Jake Eric Bentley, L.O., C.O.
Manager/part Owner
(678) 960-4424

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1780094987

South Ga Orthopedic Resources Inc's National Provider Identifier is 1780094987, issued on Apr 28, 2014. The primary taxonomy on file is Prosthetic/Orthotic Supplier (335E00000X), and the practice location is in Gainesville, GA. The record was last updated on Jan 20, 2026.