1497954093 NPI number — ORTHOPAEDIC & SPINE SURGERY OF ATLANTA

Table of content: TYLER ENG PT, DPT (NPI 1427537406)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497954093 NPI number — ORTHOPAEDIC & SPINE SURGERY OF ATLANTA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ORTHOPAEDIC & SPINE SURGERY OF ATLANTA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497954093
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/23/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3161 HOWELL MILL ROAD
Provider Second Line Business Mailing Address:
SUITE 400
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30327
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
404-351-5812
Provider Business Mailing Address Fax Number:
404-351-6017

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3161 HOWELL MILL ROAD
Provider Second Line Business Practice Location Address:
SUITE 400
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30327
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-351-5812
Provider Business Practice Location Address Fax Number:
404-351-6017
Provider Enumeration Date:
07/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HUNT
Authorized Official First Name:
MARCI
Authorized Official Middle Name:
Authorized Official Title or Position:
BILLING MANAGER
Authorized Official Telephone Number:
404-351-5812

Provider Taxonomy Codes

  • Taxonomy code: 261QM2500X , with the licence number:  029604 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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