1598942773 NPI number — ALBANY BONE & JOINT CLINIC, P.C.

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 1598942773 NPI number — ALBANY BONE & JOINT CLINIC, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALBANY BONE & JOINT CLINIC, P.C.
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:
6
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:
1598942773
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/30/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 407
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALBANY
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
31702-0407
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
229-883-4707
Provider Business Mailing Address Fax Number:
229-883-1189

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2726 LEDO RD
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
ALBANY
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31707-7622
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
229-878-4321
Provider Business Practice Location Address Fax Number:
229-878-5156
Provider Enumeration Date:
01/30/2008

Additional Information

Authorized Official

Authorized Official Last Name:
MICHAS
Authorized Official First Name:
PAUL
Authorized Official Middle Name:
A.
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
229-883-4707

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X , with the licence number:  041172 , 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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