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General NPI Number Information
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NPI Number | 1508597741
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Entity Type | Organization
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Legal Business Name | ORTHO SPORT AND SPINE PHYSICIANS POOLER
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Dates
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Enumeration Date | 06/20/2022
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Last Update Date | 07/25/2025
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Provider Practice Location Address
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Address Line | 118 PIPEMAKERS CIR STE 100
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City | POOLER
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State | GA
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Zip | 31322-4164
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Country | US
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Telephone | 800-678-4611
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Fax | 770-234-5326
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Provider Business Mailing Address
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Address Line | 5788 ROSWELL RD
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City | ATLANTA
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State | GA
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Zip | 30328-4904
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Country | US
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Telephone | 678-752-7246
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Fax |
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Authorized Official
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Title or Position | REVENUE CYCLE MANAGEMENT DIRECTOR
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Name | FAITH A BELTZHOOVER
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Credential |
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Telephone | 800-678-4611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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