Provider Demographics
NPI:1083723738
Name:T. REX ORTHOPAEDICS, PC
Entity Type:Organization
Organization Name:T. REX ORTHOPAEDICS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:BRANCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-291-2000
Mailing Address - Street 1:1014 SYCAMORE DR STE B
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-1644
Mailing Address - Country:US
Mailing Address - Phone:404-299-1700
Mailing Address - Fax:404-299-1616
Practice Address - Street 1:1014 SYCAMORE DR STE B
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030
Practice Address - Country:US
Practice Address - Phone:404-299-1700
Practice Address - Fax:404-299-1616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA74265207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA2711Medicare ID - Type UnspecifiedMEDICARE GROUP #
GA1220400001Medicare NSC