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NPI Code Detail

MEDICARE: ATHENS BONE AND JOINT PC

MEDICARE: ATHENS BONE AND JOINT 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
1174400000XSpecialist040899GA

Other Identifiers

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

General Provider Information

NPI Number : 1689736100
Entity Type Code : Organization
Provider Name (Legal Business Name) : ATHENS BONE AND JOINT PC
Provider Business Mailing Address
First Line : 1010 PRINCE AVE
Second Line : SUITE 115 SOUTH
City : ATHENS
State : GA
Zip : 30606-5805
Country : US
Telephone Number : 706-583-9000
Fax Number : 706-353-6525
Provider Business Practice Location Address
First Line : 1010 PRINCE AVE
Second Line : SUITE 115 SOUTH
City : ATHENS
State : GA
Zip : 30606-5805
Country : US
Telephone Number : 706-583-9000
Fax Number : 706-353-6525
Authorized Official
Title or Position : OWNER
Name : DR. JOHN RICHARD DORRIS III
Credential : MD
Telephone Number : 706-583-9000
Provider Enumeration Date : 12/14/2006
Last Update Date : 10/25/2016

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Directions to “ATHENS BONE AND JOINT PC ” Practice Location

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