Healthcare Provider Details

I. General information

NPI: 1760302889
Provider Name (Legal Business Name): HARTFIELD-JACKSON SPORT & SPINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2026
Last Update Date: 07/18/2026
Certification Date: 07/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4075 CHARLES HARDY PKWY STE 137
DALLAS GA
30157-3318
US

IV. Provider business mailing address

2774 COBB PKWY NW STE 109
KENNESAW GA
30152-3497
US

V. Phone/Fax

Practice location:
  • Phone: 770-758-6909
  • Fax:
Mailing address:
  • Phone: 770-758-6909
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL HARTFIELD
Title or Position: OWNER
Credential: DC
Phone: 770-758-6909