Provider Demographics
NPI:1740394535
Name:ATLANTIC COAST ORTHOPAEDIC SPECIALISTS PLC
Entity Type:Organization
Organization Name:ATLANTIC COAST ORTHOPAEDIC SPECIALISTS PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:N
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:434-220-3727
Mailing Address - Street 1:414 ALBEMARLE SQ
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-5375
Mailing Address - Country:US
Mailing Address - Phone:434-220-3727
Mailing Address - Fax:434-220-3155
Practice Address - Street 1:414 ALBEMARLE SQ
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-5375
Practice Address - Country:US
Practice Address - Phone:434-220-3727
Practice Address - Fax:434-220-3155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAF88499Medicare UPIN
VAG09210Medicare UPIN