Healthcare Provider Details

I. General information

NPI: 1881933075
Provider Name (Legal Business Name): ORTHOPAEDIC SOLUTIONS, P. C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2013
Last Update Date: 02/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

670 S 8TH ST
GRIFFIN GA
30224-4214
US

IV. Provider business mailing address

670 S 8TH ST
GRIFFIN GA
30224-4214
US

V. Phone/Fax

Practice location:
  • Phone: 770-233-3444
  • Fax: 770-233-9400
Mailing address:
  • Phone: 770-233-3444
  • Fax: 770-233-9400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number StateGA

VIII. Authorized Official

Name: ANTENOR VELAZCO
Title or Position: PRESIDENT
Credential: M.D.
Phone: 770-233-3444