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Organization

GEORGIA COMPLEX SPINE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. STEPHEN BRUCE JAMES DO (ORTHOPAEDIC SPINE SURGEON)
(678) 521-7064
Entity
Organization

Contact information

Practice address
1368 SOUTHLAKE PLAZA DR, MORROW, GA 30260-1756
(678) 767-2569
(678) 550-9990
Mailing address
4920 ATLANTA HWY, #134, ALPHARETTA, GA 30004-2921
(678) 767-2569
(678) 550-9990

Taxonomy

Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
50385
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000911919
GA
01
1013904697
NPI
Enumeration date
10/21/2016
Last updated
10/21/2016
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