# ORTHOXPRESS OF GEORGIA

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ORTHOXPRESS OF GEORGIA
- **Other names:** OrthoXpress of Fayetteville
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1427924554
- **Legal business name:** ORTHOXPRESS OF GEORGIA
- **Authorized official:** JENNIFER C BULLOCK (PRESIDENT)
- **Authorized official phone:** (662) 534-2298

## Contact information

- **Practice address:** 104 N PARK DR STE 104, FAYETTEVILLE, GA 30214-1645
- **Practice address phone:** (470) 944-5290
- **Mailing address:** 206 OXFORD RD, NEW ALBANY, MS 38652-3115
- **Mailing address phone:** (662) 534-2227

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | — | — |
| 363A00000X | Physician Assistant | — | — | Yes |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 10/15/2025
- **Last updated:** 10/15/2025