MEDICARE: SPECIALTY ORTHOPAEDICS, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician

General Provider Information

NPI Number	:	1124568423
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPECIALTY ORTHOPAEDICS, PC

Provider Business Mailing Address
First Line	:	1240 JESSE JEWELL PKWY SE
Second Line	:	STE 300
City	:	GAINESVILLE
State	:	GA
Zip	:	30501-3862
Country	:	US
Telephone Number	:	770-534-7200
Fax Number	:

Provider Business Practice Location Address
First Line	:	1229 FRIENDSHIP RD STE 100
Second Line	:
City	:	BRASELTON
State	:	GA
Zip	:	30517-5608
Country	:	US
Telephone Number	:	770-534-7200
Fax Number	:

Authorized Official
Title or Position	:	PROVIDER
Name	:	WILLIAM WEISS
Credential	:	M.D.
Telephone Number	:	770-534-7200

Provider Enumeration Date	:	03/06/2017
Last Update Date	:	04/28/2022

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