=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871553297
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SPINE & ORTHOPEDIC CENTER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/28/2006
-----------------------------------------------------
Last Update Date | 10/09/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1287 HWY 138 SPUR #8
-----------------------------------------------------
City | JONESBORO
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30236
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 770-473-0038
-----------------------------------------------------
Fax | 770-471-4290
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1287 HWY 138 SPUR #8
-----------------------------------------------------
City | JONESBORO
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30236
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 770-473-0038
-----------------------------------------------------
Fax | 770-471-4290
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MD PRESIDENT
-----------------------------------------------------
Name | DR. PRAN N SOOD
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 770-473-0038
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207XX0801X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Trauma Physician
-----------------------------------------------------
License Number | 021593
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2081P2900X
-----------------------------------------------------
Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
-----------------------------------------------------
License Number | 021593
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------