Provider Demographics
NPI:1467638098
Name:ATLANTA ARTHRITIS CENTER, P.C.
Entity Type:Organization
Organization Name:ATLANTA ARTHRITIS CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:LANCE
Authorized Official - Last Name:SMITHERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-867-0000
Mailing Address - Street 1:1305 HEMBREE RD.
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-3810
Mailing Address - Country:US
Mailing Address - Phone:678-867-0000
Mailing Address - Fax:678-867-0003
Practice Address - Street 1:1305 HEMBREE RD.
Practice Address - Street 2:SUITE 101
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-3810
Practice Address - Country:US
Practice Address - Phone:678-867-0000
Practice Address - Fax:678-867-0003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-14
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA045973261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA52598444003OtherBCBS
GA000809465DMedicaid
GA3405853OtherCIGNA
GA5700685OtherAETNA
GA66BBBGGMedicare PIN
GA000809465DMedicaid