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GEORGIA BRAIN AND SPINE LLC NPI 1629519343


NPI Information

NPI: 1629519343
Provider Name: GEORGIA BRAIN AND SPINE LLC
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
2107 N DECATUR RD
UNIT 448
DECATUR, GA
ZIP 30033
Phone: (404) 418-0192
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GEORGIA BRAIN AND SPINE LLC is a specialist in Decatur, GA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. GEORGIA BRAIN AND SPINE LLC NPI is 1629519343. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2107 N DECATUR RD
UNIT 448
DECATUR, GA
ZIP 30033-305
Phone: (404) 418-0192
Fax: (844) 360-9946

The provider's authorized official is Amos O Dare .
The authorized official title is Medical Director and has the following contact phone number (404) 418-0192.

The enumeration date for this NPI number is 3/14/2017 and was last updated on 3/14/2017.


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
1174400000XSpecialist64353GEORGIAYes

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
164353OTHERGEORGIAMEDICAL LICENSE

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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