Healthcare Provider Details
I. General information
NPI: 1457360331
Provider Name (Legal Business Name): NORTHVIEW ORTHOPAEDIC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/07/2006
Last Update Date: 03/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
70 ANSLEY DR
DAHLONEGA GA
30533-1613
US
IV. Provider business mailing address
70 ANSLEY DR
DAHLONEGA GA
30533-1613
US
V. Phone/Fax
- Phone: 706-864-7904
- Fax: 706-894-0432
- Phone: 706-864-7904
- Fax: 706-894-0432
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
GERALD
ALAN
BINKLEY
Title or Position: OWNER
Credential: M.D.
Phone: 706-864-7904