Healthcare Provider Details

I. General information

NPI: 1427763796
Provider Name (Legal Business Name): ACUTE SPINE & JOINT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2023
Last Update Date: 01/20/2023
Certification Date: 01/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 JESSE JEWELL PKWY SW STE 200
GAINESVILLE GA
30501-4212
US

IV. Provider business mailing address

800 JESSE JEWELL PKWY SW STE 200
GAINESVILLE GA
30501-4212
US

V. Phone/Fax

Practice location:
  • Phone: 404-964-6571
  • Fax: 404-393-7324
Mailing address:
  • Phone: 404-964-6571
  • Fax: 404-393-7324

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ANTHONY F HUMAN
Title or Position: OWNER
Credential: DO
Phone: 678-689-5200