# ORTHOPEDIC SURGEONS OF GEORGIA LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Orthopedic Surgeons of Georgia - Homerville
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477042935
- **Authorized official:** LAVONDA LOTT CRAVEY (VP OF CORPORATE REVENUE CYCLE)
- **Authorized official phone:** (912) 384-1900

## Contact information

- **Practice address:** 1050 VALDOSTA HWY, HOMERVILLE, GA 31634-9701
- **Practice address phone:** (912) 383-6575
- **Practice address fax:** (912) 383-6476
- **Mailing address:** PO BOX 1377, DOUGLAS, GA 31534-1377
- **Mailing address phone:** (912) 384-1477

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | — |
| 207X00000X | Orthopaedic Surgery Physician | — | — | — |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | Yes |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/09/2018
- **Last updated:** 03/30/2022