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GEORGIA SPINE & NEUROSURGERY CENTER LLC NPI 1760684609


NPI Information

NPI: 1760684609
Provider Name: GEORGIA SPINE & NEUROSURGERY CENTER LLC
Classification: Neurological Surgery - 207T00000X
Entity Type: Organization
Address:
2675 N DECATUR RD
SUITE 110
DECATUR, GA
ZIP 30033
Phone: (404) 299-3338
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GEORGIA SPINE & NEUROSURGERY CENTER LLC is a neurological surgery in Decatur, GA. The provider is a neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. GEORGIA SPINE & NEUROSURGERY CENTER LLC NPI is 1760684609. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2675 N DECATUR RD
SUITE 110
DECATUR, GA
ZIP 30033-131
Phone: (404) 299-3338
Fax: (404) 299-3315

The provider's authorized official is Kaveh Khajavi .
The authorized official title is Owner and has the following contact phone number (404) 299-3338.

The enumeration date for this NPI number is 6/4/2007 and was last updated on 2/7/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207T00000XNeurological Surgery51201GEORGIAYes
2332BC3200XDurable Medical Equipment & Medical SuppliesCustomized Equipment51201GEORGIANo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11972627396OTHERDME NPI
2931766736AMEDICAIDGEORGIA
31093771891OTHERMIHELIC NPI
4H29606MEDICARE UPIN
5Q09023MEDICARE UPIN
61306807094OTHERGULLICK NPI
71487610275OTHERKHAJAVI NPI
814BDHHKMEDICARE ID-TYPE UNSPECIFIEDKHAJAVI
997WCFJBMEDICARE ID-TYPE UNSPECIFIEDMIHELIC
1000944358BMEDICAIDGEORGIA
114918650001MEDICARE NSC

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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