Provider Demographics
NPI:1568799302
Name:ROSENBAUM ORTHOPAEDICS, LLC
Entity Type:Organization
Organization Name:ROSENBAUM ORTHOPAEDICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:HESTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-448-4050
Mailing Address - Street 1:PO BOX 4128
Mailing Address - Street 2:
Mailing Address - City:EASTMAN
Mailing Address - State:GA
Mailing Address - Zip Code:31023-4128
Mailing Address - Country:US
Mailing Address - Phone:478-374-2490
Mailing Address - Fax:478-374-0337
Practice Address - Street 1:1103 PLAZA AVE
Practice Address - Street 2:
Practice Address - City:EASTMAN
Practice Address - State:GA
Practice Address - Zip Code:31023-6788
Practice Address - Country:US
Practice Address - Phone:478-374-2490
Practice Address - Fax:478-374-0337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-16
Last Update Date:2011-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty