Provider Demographics
NPI:1427045558
Name:NORTH DEKALB ORTHOPEDICS P.C.
Entity Type:Organization
Organization Name:NORTH DEKALB ORTHOPEDICS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:F
Authorized Official - Last Name:RICHIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-294-4111
Mailing Address - Street 1:505 IRVIN CT
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-1706
Mailing Address - Country:US
Mailing Address - Phone:404-294-4111
Mailing Address - Fax:404-292-3505
Practice Address - Street 1:505 IRVIN CT
Practice Address - Street 2:SUITE 200
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-1706
Practice Address - Country:US
Practice Address - Phone:404-294-4111
Practice Address - Fax:404-292-3505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0817660001Medicare NSC