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General NPI Number Information
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NPI Number | 1407197551
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Entity Type | Organization
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Legal Business Name | ATLANTA AREA ORTHOPEDIC & IMAGING, LLC
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Dates
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Enumeration Date | 03/13/2013
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Last Update Date | 03/14/2013
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Provider Practice Location Address
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Address Line | 601A PROFESSIONAL DRIVE STE. 130
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046
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Country | US
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Telephone | 678-551-7800
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Fax | 678-551-7802
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Provider Business Mailing Address
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Address Line | PO BOX 150
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City | WATKINSVILLE
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State | GA
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Zip | 30677-0004
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Country | US
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Telephone | 678-551-7800
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Fax | 678-551-7802
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Authorized Official
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Title or Position | OWNER
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Name | DAVID G DILLARD
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Credential | M.D.
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Telephone | 706-247-1775
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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