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General NPI Number Information
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NPI Number | 1629062336
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Entity Type | Organization
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Legal Business Name | RIVER CITY ORTHOPAEDICS AND SPINE MEDICINE CENTER PC
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Dates
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Enumeration Date | 09/08/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1900 10TH AVE STE 320
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City | COLUMBUS
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State | GA
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Zip | 31901-3600
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Country | US
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Telephone | 706-653-6635
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Fax | 706-653-8543
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Provider Business Mailing Address
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Address Line | 1900 10TH AVE STE 320
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City | COLUMBUS
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State | GA
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Zip | 31901-3600
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Country | US
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Telephone | 706-653-6635
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Fax | 706-653-8543
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Authorized Official
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Title or Position | OWNER FOUNDER CEO MD
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Name | EMORY JEVODE ALEXANDER
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Credential | MD
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Telephone | 706-653-6635
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 39717
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License Number State | GA
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