Healthcare Provider Details

I. General information

NPI: 1033031380
Provider Name (Legal Business Name): B AND B ORTHOPEDICS AND SPINE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1785 E PARK PLACE BLVD UNIT 870111
STONE MOUNTAIN GA
30087-9998
US

IV. Provider business mailing address

PO BOX 870111
STONE MOUNTAIN GA
30087-0003
US

V. Phone/Fax

Practice location:
  • Phone: 678-707-8734
  • Fax: 678-449-0102
Mailing address:
  • Phone: 678-707-8734
  • Fax: 678-449-0102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. BRETT MICHAEL ROSENBERG
Title or Position: PHYSICIAN
Credential: MD
Phone: 678-892-5590