National Provider Identifier Database

SOUTH ATL ORTHO SPTS
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

SOUTH ATL ORTHO & SPTS
425 FOREST PARKWAY
SUITE 111
FOREST PARK, GA30297-2342
Phone: 404-362-9935
Fax: 404-362-9938
Website:
Specialty Taxonomy Code
* Medical Specialty 261QM2500X

* Indicates primary specialty

NPI Profile & details for SOUTH ATL ORTHO & SPTS

NPI Number 1639368459
Legal business name
LBN
SOUTH ATL ORTHO & SPTS
Authorized official ALEXANDER DOMAN - (OWNER/PRESIDENT)
Entity Organization
Organization subpart Yes
Enumeration date 10/17/2007
Last updated 10/02/2009 - About 17 years ago
Sole proprietor1 Not specified
Identifiers
  • GA License #: 033313
  • GA Medicaid: 000444881A

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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