# DECATUR ORTHO-NEURO GROUP LLC

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

## Provider details

- **NPI number:** 1437543394
- **Authorized official:** RANDY MAYFIELD (MEMBER)
- **Authorized official phone:** (404) 373-0400

## Contact information

- **Practice address:** 1376 CHURCH ST, DECATUR, GA 30030-1519
- **Practice address phone:** (404) 373-0400
- **Mailing address:** 1376 CHURCH ST, DECATUR, GA 30030-1519

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081S0010X | Sports Medicine (Physical Medicine & Rehabilitation) Physician | — | GA | Yes |

## Other

- **Enumeration date:** 03/27/2015
- **Last updated:** 04/15/2015