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General NPI Number Information
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NPI Number | 1659405546
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Entity Type | Organization
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Legal Business Name | THE BONE & JOINT ORTHOPAEDIC SURGERY CLINIC, P. C.
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 01/12/2009
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Provider Practice Location Address
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Address Line | 620 SPARTA RD
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City | SANDERSVILLE
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State | GA
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Zip | 31082-1803
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Country | US
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Telephone | 478-552-9402
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Fax | 478-552-0645
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Provider Business Mailing Address
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Address Line | 620 SPARTA RD
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City | SANDERSVILLE
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State | GA
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Zip | 31082-1803
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Country | US
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Telephone | 478-552-9402
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Fax | 478-552-0645
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERTO H BARJA
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Credential | M. D.
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Telephone | 478-552-9402
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 039020
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License Number State | GA
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