Provider Demographics
NPI:1306038807
Name:DUBLIN ORTHOPAEDICS & REHABILITATION, INC
Entity Type:Organization
Organization Name:DUBLIN ORTHOPAEDICS & REHABILITATION, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:D
Authorized Official - Last Name:PETERS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:478-272-3022
Mailing Address - Street 1:2400 BELLEVUE RD STE 15
Mailing Address - Street 2:PO BOX 368
Mailing Address - City:DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31021-2894
Mailing Address - Country:US
Mailing Address - Phone:478-272-3022
Mailing Address - Fax:478-272-4233
Practice Address - Street 1:2400 BELLEVUE RD STE 15
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-2894
Practice Address - Country:US
Practice Address - Phone:478-272-3022
Practice Address - Fax:478-272-4233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-17
Last Update Date:2015-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA022866174400000X
GA036595174400000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00539569AMedicaid
GA00249235CMedicaid
GAF51723Medicare UPIN
GAD42195Medicare UPIN
GA20BDBWHOtherMEDICARE PROVIDER #
GA00249235CMedicaid