Provider Demographics
NPI:1609823343
Name:PARKWAY ORTHOPAEDIC CENTER, PC
Entity Type:Organization
Organization Name:PARKWAY ORTHOPAEDIC CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:J
Authorized Official - Last Name:MULHERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-858-0580
Mailing Address - Street 1:4700 BATTLEFIELD PKWY
Mailing Address - Street 2:SUUITE 320
Mailing Address - City:RINGGOLD
Mailing Address - State:GA
Mailing Address - Zip Code:30736-5166
Mailing Address - Country:US
Mailing Address - Phone:706-858-0580
Mailing Address - Fax:423-495-7887
Practice Address - Street 1:4700 BATTLEFIELD PKWY
Practice Address - Street 2:SUUITE 320
Practice Address - City:RINGGOLD
Practice Address - State:GA
Practice Address - Zip Code:30736-5166
Practice Address - Country:US
Practice Address - Phone:706-858-0580
Practice Address - Fax:423-495-7887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3735673Medicare ID - Type Unspecified
GAGRP6112Medicare ID - Type Unspecified