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Organization

GEORGIA SPINE SPECIALISTS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MIGUEL A JIMENEZ MD (CEO)
(770) 374-3714
Entity
Organization

Contact information

Practice address
3903 S COBB DR SE, STE 105, SMYRNA, GA 30080-8504
(678) 838-6600
(770) 438-1477
Mailing address
11 MAYBELLE ST, CARTERSVILLE, GA 30120-3615
(770) 334-2065
(770) 334-2066

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
52966
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
GRP7885
MEDICARE GROUP NUMBER
GA
Enumeration date
03/31/2011
Last updated
03/31/2011
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