# SOUTH ATL ORTHO & SPTS

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SOUTH ATLANTA ORTHOPEDICS & SPORTS MEDICINE
- **Other names:** Alexander N. Doman, MD
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1639368459
- **Legal business name:** SOUTH ATLANTA ORTHOPEDICS & SPORTS MEDICINE
- **Authorized official:** DR. ALEXANDER NICHOLAS DOMAN M.D. (OWNER/PRESIDENT)
- **Authorized official phone:** (404) 362-9935

## Contact information

- **Practice address:** 425 FOREST PARKWAY, SUITE 111, FOREST PARK, GA 30297-2342
- **Practice address phone:** (404) 362-9935
- **Practice address fax:** (404) 362-9938
- **Mailing address:** 425 FOREST PKWY, SUITE111, FOREST PARK, GA 30297-2185
- **Mailing address phone:** (404) 362-9935
- **Mailing address fax:** (404) 362-9938

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 033313 | GA | Yes |

## Other

- **Enumeration date:** 10/17/2007
- **Last updated:** 10/02/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 000444881A | — | GA |