=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700298312
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AICA ORTHOPEDICS, P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/30/2014
-----------------------------------------------------
Last Update Date | 06/16/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2375 WALL ST SE UNIT 135
-----------------------------------------------------
City | CONYERS
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30013-6702
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 678-210-2225
-----------------------------------------------------
Fax | 678-210-2226
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 500067
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30350
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 678-701-2225
-----------------------------------------------------
Fax | 678-701-2226
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. FRANCIS K ACQUAH
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 770-968-5611
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207XX0801X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Trauma Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------