Provider Demographics
NPI:1083049464
Name:ORTHOPAEDIC IME SPECIALISTS, LLC
Entity Type:Organization
Organization Name:ORTHOPAEDIC IME SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBYSINA
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-855-3339
Mailing Address - Street 1:4279 ROSWELL RD NE
Mailing Address - Street 2:SUITE 102-329
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-3769
Mailing Address - Country:US
Mailing Address - Phone:404-855-3339
Mailing Address - Fax:404-255-2170
Practice Address - Street 1:550 PEACHTREE ST NE
Practice Address - Street 2:SUITE 1075
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2208
Practice Address - Country:US
Practice Address - Phone:404-855-3339
Practice Address - Fax:404-255-2170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-04
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA029684202C00000X, 207X00000X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes202C00000XAllopathic & Osteopathic PhysiciansIndependent Medical ExaminerGroup - Single Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty