MEDICARE: ALBANY BONE & JOINT CLINIC 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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295709178
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALBANY BONE & JOINT CLINIC PC

Provider Business Mailing Address
First Line	:	PO BOX 407
Second Line	:
City	:	ALBANY
State	:	GA
Zip	:	31702-0407
Country	:	US
Telephone Number	:	229-883-4707
Fax Number	:	229-435-1038

Provider Business Practice Location Address
First Line	:	619 POINTE NORTH BLVD
Second Line	:
City	:	ALBANY
State	:	GA
Zip	:	31721-1514
Country	:	US
Telephone Number	:	229-883-4707
Fax Number	:	229-435-1038

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	CHERYL BOYLES
Credential	:	CPC
Telephone Number	:	229-883-4707

Provider Enumeration Date	:	02/15/2006
Last Update Date	:	10/17/2023

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