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SPINE CENTER ATLANTA SOUTH LLC NPI 1548795719


NPI Information

NPI: 1548795719
Provider Name: SPINE CENTER ATLANTA SOUTH, LLC

Former Legal Business Name: SPINE CENTER RIVERDALE, LLC

Classification: Orthopaedic Surgery - 207X00000X
Entity Type: Organization
Address:
102 VINCENT AVE.
STOCKBRIDGE, GA
ZIP 30281
Phone: (678) 974-0158
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SPINE CENTER ATLANTA SOUTH, LLC is an orthopaedic surgery in Stockbridge, GA. The provider is an orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. SPINE CENTER ATLANTA SOUTH, LLC NPI is 1548795719. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Spine Center Riverdale, Llc.

The provider's business location address is:

102 VINCENT AVE.
STOCKBRIDGE, GA
ZIP 30281-049
Phone: (678) 974-0158
Fax: (678) 608-3217

The provider's authorized official is Steven Weidler .
The authorized official title is Chief Operating Officer and has the following contact phone number (404) 351-5812.

The enumeration date for this NPI number is 4/25/2017 and was last updated on 12/14/2018.


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
1208100000XPhysical Medicine & Rehabilitation063309GEORGIANo
2208VP0000XPain MedicinePain MedicineNo
3207X00000XOrthopaedic SurgeryYes

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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