# SPINE AND ORTHOPEDICS OF ATLANTA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265802318
- **Authorized official:** DR. DAMIEN DOUTE MD (OWNER/PHYSICIAN)
- **Authorized official phone:** (470) 440-5848

## Contact information

- **Practice address:** 1462 MONTREAL RD STE 218, TUCKER, GA 30084
- **Practice address phone:** (470) 294-0863
- **Practice address fax:** (470) 294-0889
- **Mailing address:** 1462 MONTREAL RD STE 218, TUCKER, GA 30084-6931

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/01/2015
- **Last updated:** 09/06/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 728513163A | — | GA |