Provider Demographics
NPI:1598942773
Name:ALBANY BONE & JOINT CLINIC, P.C.
Entity Type:Organization
Organization Name:ALBANY BONE & JOINT CLINIC, P.C.
Other - Org Name:ORTHOPAEDIC ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:A
Authorized Official - Last Name:MICHAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:229-883-4707
Mailing Address - Street 1:PO BOX 407
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31702-0407
Mailing Address - Country:US
Mailing Address - Phone:229-883-4707
Mailing Address - Fax:229-883-1189
Practice Address - Street 1:2726 LEDO RD
Practice Address - Street 2:SUITE 2
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707-7622
Practice Address - Country:US
Practice Address - Phone:229-878-4321
Practice Address - Fax:229-878-5156
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALBANY BONE & JOINT CLINIC, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-30
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA041172207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty