MEDICARE: ARCADE KINGS,LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	204C00000X	Sports Medicine (Neuromusculoskeletal Medicine) Physician

General Provider Information

NPI Number	:	1730209446
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARCADE KINGS,LLC

Provider Business Mailing Address
First Line	:	2770 LENOX RD
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30324
Country	:	US
Telephone Number	:	404-264-9553
Fax Number	:	404-266-2294

Provider Business Practice Location Address
First Line	:	2770 LENOX RD NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30324-6006
Country	:	US
Telephone Number	:	404-264-9553
Fax Number	:	404-266-2294

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SCOTT FRIEDER
Credential	:
Telephone Number	:	404-264-9553

Provider Enumeration Date	:	03/29/2007
Last Update Date	:	08/22/2020

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Directions to “ARCADE KINGS,LLC ” Practice Location

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