Provider Demographics
NPI:1710998604
Name:GWINNETT ORTHOPEDICS PC
Entity Type:Organization
Organization Name:GWINNETT ORTHOPEDICS PC
Other - Org Name:ATLANTA ORTHOPEDICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-963-6300
Mailing Address - Street 1:545 OLD NORCROSS RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30045-3389
Mailing Address - Country:US
Mailing Address - Phone:770-963-6300
Mailing Address - Fax:678-287-1664
Practice Address - Street 1:545 OLD NORCROSS RD
Practice Address - Street 2:SUITE 300
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30045-3389
Practice Address - Country:US
Practice Address - Phone:770-963-6300
Practice Address - Fax:678-287-1664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP4460Medicare PIN