MEDICARE: ARTHRITIS CENTER OF NORTH GEORGIA LLC

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	207RR0500X	Rheumatology Physician		GA

General Provider Information

NPI Number	:	1801153390
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARTHRITIS CENTER OF NORTH GEORGIA LLC

Provider Business Mailing Address
First Line	:	961 SMOKY MOUNTAIN SPRINGS LN NE
Second Line	:	STE A
City	:	GAINESVILLE
State	:	GA
Zip	:	30501-2418
Country	:	US
Telephone Number	:	770-531-3711
Fax Number	:	770-531-3718

Provider Business Practice Location Address
First Line	:	961 SMOKY MOUNTAIN SPRINGS LN NE
Second Line	:	STE A
City	:	GAINESVILLE
State	:	GA
Zip	:	30501-2418
Country	:	US
Telephone Number	:	770-531-3711
Fax Number	:	770-531-3718

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MARTA T BOGNAR
Credential	:	MD
Telephone Number	:	770-531-3711

Provider Enumeration Date	:	04/20/2012
Last Update Date	:	07/21/2022

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