Provider Demographics
NPI:1841527819
Name:MOUNTAIN MEDICAL SPECILITIES INC
Entity type:Organization
Organization Name:MOUNTAIN MEDICAL SPECILITIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:B
Authorized Official - Last Name:FLICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-782-4799
Mailing Address - Street 1:156 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:GA
Mailing Address - Zip Code:30525-4266
Mailing Address - Country:US
Mailing Address - Phone:706-782-4799
Mailing Address - Fax:706-782-0922
Practice Address - Street 1:156 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:GA
Practice Address - Zip Code:30525-4266
Practice Address - Country:US
Practice Address - Phone:706-782-4799
Practice Address - Fax:706-782-0922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-11
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003112185AMedicaid
GA003112185AMedicaid