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General NPI Number Information
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NPI Number | 1083723738
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Entity Type | Organization
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Legal Business Name | T. REX ORTHOPAEDICS, PC
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 08/01/2018
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Provider Practice Location Address
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Address Line | 1014 SYCAMORE DR STE B
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City | DECATUR
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State | GA
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Zip | 30030
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Country | US
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Telephone | 404-299-1700
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Fax | 404-299-1616
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Provider Business Mailing Address
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Address Line | 1014 SYCAMORE DR STE B
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City | DECATUR
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State | GA
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Zip | 30030-1644
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Country | US
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Telephone | 404-299-1700
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Fax | 404-299-1616
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THOMAS PAUL BRANCH
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Credential | M.D.
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Telephone | 404-291-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number | 74265
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License Number State | GA
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