CUSTOM PROSTHETIC & ORTHOTIC
NPI 1710147301
Prosthetic/Orthotic Supplier in Clinton, MS

Active since June 17, 2008
801 E NORTHSIDE DR, SUITE - D, CLINTON, MS 39056(601) 906-1024 Get Directions Write a Review

NPPES record last updated: March 15, 2012. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Custom Prosthetic & Orthotic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CUSTOM PROSTHETIC & ORTHOTIC (NPI 1710147301) is a healthcare organization registered as a prosthetic/orthotic supplier in Clinton, Mississippi and active in the NPI registry since June 2008. The organization lists Johnnie Mae Owens, Owner President, as its authorized official.

NPPES Registry Identity

NPI1710147301
Entity TypeOrganization
Primary Taxonomy335E00000X
Legal Business NameCUSTOM PROSTHETIC & ORTHOTIC
Location Address801 E NORTHSIDE DR, SUITE - DClinton, MS 39056-3663
Mailing Address801 E Northside Dr, Suite - DClinton, MS 39056-3663 · (601) 906-1024
Organization SubpartNo
Authorized OfficialJohnnie Mae OwensOwner President · (601) 906-1024
Enumeration DateJune 17, 2008
Last NPPES UpdateMarch 15, 2012
NPI 1710147301 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyProsthetic/Orthotic SupplierSuppliers
Taxonomy Code335E00000X
Definition

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.

801 E NORTHSIDE DR, Clinton, MS 39056

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Specialist (Prosthetics Case Management)
801 E NORTHSIDE DR, SUITE D
CLINTON, MS 39056
Orthotic Fitter
801 E NORTHSIDE DR, SUITE D
CLINTON, MS 39056
Prosthetic/Orthotic Supplier
801 E NORTHSIDE DR, SUITE D
CLINTON, MS 39056

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Custom Prosthetic & Orthotic's NPI number?

The NPI number for Custom Prosthetic & Orthotic is 1710147301. It was assigned to this organization in the NPPES registry on June 17, 2008.

Where is Custom Prosthetic & Orthotic located?

Custom Prosthetic & Orthotic is located at 801 E Northside Dr Suite - D, Clinton, MS 39056. The listed phone number is (601) 906-1024.

What is Custom Prosthetic & Orthotic's specialty?

The primary specialty registered for this NPI is Prosthetic/Orthotic Supplier with taxonomy code 335E00000X.

When was this NPI record last updated?

The NPPES record for Custom Prosthetic & Orthotic was last updated on March 15, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.