Healthcare Provider Details

I. General information

NPI: 1992159263
Provider Name (Legal Business Name): DANIEL ROBERT VERHOTZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2016
Last Update Date: 09/06/2022
Certification Date: 09/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2860 RONALD REAGAN BLVD STE 300
CUMMING GA
30041-6092
US

IV. Provider business mailing address

2001 PEACHTREE RD NE STE 205
ATLANTA GA
30309-1476
US

V. Phone/Fax

Practice location:
  • Phone: 404-355-0743
  • Fax: 855-283-8851
Mailing address:
  • Phone: 404-355-0743
  • Fax: 404-355-2136

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number2021019473
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number2021019473
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number92115
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: