Orthoatlanta, LLC
Orthopaedic Surgery in Brookhaven, GA. Organization (NPI-2).
NPI number1265047005
StatusActive
Last updated in NPPESMar 24, 2025
Details
- NPI
- 1265047005
- Entity type
- Organization (NPI-2)
- Legal business name
- Orthoatlanta, LLC
- Organization subpart
- No
- Enumeration date
- Sep 9, 2020
- Certification date
- Mar 24, 2025
- Last updated
- Mar 24, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207X00000X | Orthopaedic Surgery | – | – | Yes |
| 207XS0106X | Orthopaedic Surgery, Hand Surgery | – | – | |
| 207XX0005X | Orthopaedic Surgery, Sports Medicine | – | – | |
| 208100000X | Physical Medicine & Rehabilitation | – | – | |
| 2081P2900X | Physical Medicine & Rehabilitation, Pain Medicine | – | – | |
| 225X00000X | Occupational Therapist | – | – | |
| 261QM1300X | Clinic/Center, Multi-Specialty | – | – |
Practice location
3929 Peachtree Rd Ne Ste 250Brookhaven, GA 30319-3374
Phone 404-352-1053 · Fax 404-350-0840
Mailing address
900 Circle 75 Pkwy Se Ste 1700Atlanta, GA 30339-3087
Phone 770-953-6929
Authorized official
Teyanna Conyers
Director Of Credentialing
6786804945
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