Provider Demographics
NPI:1932525375
Name:ORTHO SPORT & SPINE PHYSICIANS
Entity Type:Organization
Organization Name:ORTHO SPORT & SPINE PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RCM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FAITH
Authorized Official - Middle Name:A
Authorized Official - Last Name:BELTZHOOVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-752-7246
Mailing Address - Street 1:5788 ROSWELL RD
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-4904
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5788 ROSWELL RD
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-4904
Practice Address - Country:US
Practice Address - Phone:404-935-9110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-10
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty