Provider Demographics
NPI:1780819409
Name:O'BRIEN ORTHOPEDICS, INC.
Entity Type:Organization
Organization Name:O'BRIEN ORTHOPEDICS, INC.
Other - Org Name:O'BRIEN ORTHOPEDICS, L.L.C..
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER, PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:J
Authorized Official - Last Name:SORENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-542-0897
Mailing Address - Street 1:102 HINES RD NE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:CALHOUN
Mailing Address - State:GA
Mailing Address - Zip Code:30701-9374
Mailing Address - Country:US
Mailing Address - Phone:706-624-9494
Mailing Address - Fax:706-624-9191
Practice Address - Street 1:15 MEDICAL DR NE
Practice Address - Street 2:SUITE 304
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30121-8005
Practice Address - Country:US
Practice Address - Phone:678-721-6800
Practice Address - Fax:678-721-6803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-26
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000011335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA5833230002Medicare NSC
GA5833230001Medicare NSC