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General NPI Number Information
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NPI Number | 1659376275
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Entity Type | Organization
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Legal Business Name | ATLANTA BRAIN AND SPINE CARE, P.C.
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Dates
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Enumeration Date | 06/20/2005
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Last Update Date | 02/10/2012
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Provider Practice Location Address
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Address Line | 2001 PEACHTREE RD NE STE 575
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City | ATLANTA
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State | GA
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Zip | 30309-1476
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Country | US
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Telephone | 404-350-0106
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Fax | 404-350-0176
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Provider Business Mailing Address
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Address Line | 2001 PEACHTREE RD NE STE 575
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City | ATLANTA
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State | GA
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Zip | 30309-1476
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Country | US
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Telephone | 404-350-0106
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Fax | 404-350-0176
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Authorized Official
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Title or Position | SECRETARY / TREASURER
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Name | REGIS WILLIAM HAID JR.
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Credential | M.D.
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Telephone | 404-350-0106
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | 089949 LGB
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License Number State | GA
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