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
Update your record
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