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GEORGIA COMPLEX SPINE LLC NPI 1083165252


NPI Information

NPI: 1083165252
Provider Name: GEORGIA COMPLEX SPINE, LLC
Classification: Orthopaedic Surgery - 207XS0117X
Entity Type: Organization

Specialization: Orthopaedic Surgery of the Spine

Address:
1368 SOUTHLAKE PLAZA DR
MORROW, GA
ZIP 30260
Phone: (678) 767-2569
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GEORGIA COMPLEX SPINE, LLC is an orthopaedic surgery of the spine orthopaedic surgery in Morrow, GA. The provider is recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive. GEORGIA COMPLEX SPINE, LLC NPI is 1083165252. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1368 SOUTHLAKE PLAZA DR
MORROW, GA
ZIP 30260-756
Phone: (678) 767-2569
Fax: (678) 550-9990

The provider's authorized official is Stephen Bruce James .
The authorized official title is Orthopaedic Spine Surgeon and has the following contact phone number (678) 521-7064.

The enumeration date for this NPI number is 10/21/2016 and was last updated on 10/21/2016.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207XS0117XOrthopaedic SurgeryOrthopaedic Surgery of the Spine50385GEORGIAYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11013904697OTHERNPI
2000911919MEDICAIDGEORGIA
3F33211MEDICARE UPIN

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: 5/5/2024

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