1801233671 NPI number — ORTHOPAEDIC SOLUTIONS, PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801233671 NPI number — ORTHOPAEDIC SOLUTIONS, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ORTHOPAEDIC SOLUTIONS, PC
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:
1801233671
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/03/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
670 S 8TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRIFFIN
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30224-4214
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
770-233-3444
Provider Business Mailing Address Fax Number:
770-997-3002

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6525 PROFESSIONAL PL
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
RIVERDALE
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30274-2519
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
770-233-3444
Provider Business Practice Location Address Fax Number:
770-997-3002
Provider Enumeration Date:
06/03/2013

Additional Information

Authorized Official

Authorized Official Last Name:
VELAZCO
Authorized Official First Name:
ANTENOR
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT/OWNER
Authorized Official Telephone Number:
770-233-3444

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X , with the licence number:  21931 , 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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