MEDICARE: ORTHOPEDIC SURGERY, P.C.

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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1720156243
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORTHOPEDIC SURGERY, P.C.

Provider Business Mailing Address
First Line	:	4055 JOHNS CREEK PKWY
Second Line	:	SUITE A
City	:	SUWANEE
State	:	GA
Zip	:	30024-1299
Country	:	US
Telephone Number	:	678-957-3040
Fax Number	:	678-957-3047

Provider Business Practice Location Address
First Line	:	4055 JOHNS CREEK PKWY
Second Line	:	SUITE A
City	:	SUWANEE
State	:	GA
Zip	:	30024-1299
Country	:	US
Telephone Number	:	678-957-3040
Fax Number	:	678-957-3047

Authorized Official
Title or Position	:	PRACTICE MANAGER
Name	:	LUCY M. DENZIN
Credential	:	MHA
Telephone Number	:	678-957-3040

Provider Enumeration Date	:	12/01/2006
Last Update Date	:	03/19/2008

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