Provider Demographics
NPI:1659376275
Name:ATLANTA BRAIN AND SPINE CARE, P.C.
Entity Type:Organization
Organization Name:ATLANTA BRAIN AND SPINE CARE, P.C.
Other - Org Name:ROBINSON NEUROSURGICAL
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:SECRETARY / TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:REGIS
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:HAID
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:404-350-0106
Mailing Address - Street 1:2001 PEACHTREE RD NE STE 575
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1476
Mailing Address - Country:US
Mailing Address - Phone:404-350-0106
Mailing Address - Fax:404-350-0176
Practice Address - Street 1:2001 PEACHTREE RD NE STE 575
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1476
Practice Address - Country:US
Practice Address - Phone:404-350-0106
Practice Address - Fax:404-350-0176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-20
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA089949 LGB207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DA7904OtherRAILROAD MEDICARE
DA7904OtherRAILROAD MEDICARE