Provider Demographics
NPI:1003879982
Name:GEORGIA BONE & JOINT SURGEONS, P.C,
Entity Type:Organization
Organization Name:GEORGIA BONE & JOINT SURGEONS, P.C,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCREARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-386-5221
Mailing Address - Street 1:15 MEDICAL DR NE STE 101
Mailing Address - Street 2:
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30121-8005
Mailing Address - Country:US
Mailing Address - Phone:770-386-5221
Mailing Address - Fax:770-382-2591
Practice Address - Street 1:15 MEDICAL DR NE STE 101
Practice Address - Street 2:
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30121-8005
Practice Address - Country:US
Practice Address - Phone:770-386-5221
Practice Address - Fax:770-382-2591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-10
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP2150Medicare PIN
GA0914940001Medicare NSC