National Provider Identifier Database

SPINE AND ORTHOPEDICS OF ATLANTA LLC
Medical Specialty

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).


Contact Information

SPINE AND ORTHOPEDICS OF ATLANTA, LLC
1462 MONTREAL RD STE 218
TUCKER, GA30084
Phone: 470-294-0863
Fax: 470-294-0889
Website:
Specialty Taxonomy Code
* Medical Specialty 261QM2500X

* Indicates primary specialty

NPI Profile & details for SPINE AND ORTHOPEDICS OF ATLANTA, LLC

NPI Number 1265802318
Legal business name
LBN
SPINE AND ORTHOPEDICS OF ATLANTA, LLC
Authorized official DAMIEN DOUTE - (OWNER/PHYSICIAN)
Entity Organization
Organization subpart No
Enumeration date 10/01/2015
Last updated 09/06/2018 - About 8 years ago
Sole proprietor1 Not specified
Identifiers
  • GA Medicaid: 728513163A

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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