Provider Demographics
NPI:1376147983
Name:ORTHOPEDIC CORTISONE INJECTION CENTER
Entity Type:Organization
Organization Name:ORTHOPEDIC CORTISONE INJECTION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:RICHIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-292-3538
Mailing Address - Street 1:1705 MOUNT VERNON RD STE B
Mailing Address - Street 2:
Mailing Address - City:DUNWOODY
Mailing Address - State:GA
Mailing Address - Zip Code:30338-4257
Mailing Address - Country:US
Mailing Address - Phone:404-292-3538
Mailing Address - Fax:404-296-0663
Practice Address - Street 1:1705 MOUNT VERNON RD STE B
Practice Address - Street 2:
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-4257
Practice Address - Country:US
Practice Address - Phone:404-292-3538
Practice Address - Fax:404-296-0663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-24
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty