Provider Demographics
NPI:1669406591
Name:GEORGIA HAND , SHOULDER AND ELBOW, P.C.
Entity type:Organization
Organization Name:GEORGIA HAND , SHOULDER AND ELBOW, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:HOUSTON
Authorized Official - Last Name:PAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-352-3522
Mailing Address - Street 1:1819 PEACHTREE RD NE
Mailing Address - Street 2:SUITE 425
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1848
Mailing Address - Country:US
Mailing Address - Phone:404-352-3522
Mailing Address - Fax:404-601-1235
Practice Address - Street 1:2061 PEACHTREE RD NE STE 500
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1446
Practice Address - Country:US
Practice Address - Phone:404-352-3522
Practice Address - Fax:404-601-1235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP1073Medicare ID - Type Unspecified
GA5811800001Medicare NSC