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Organization

ATL ORTHOPEDICS MEDICAL GROUP LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LATRICIA BASS (CEO)
(404) 662-3585
Entity
Organization

Contact information

Practice address
3885 PRINCETON LAKES WAY SW STE 306, ATLANTA, GA 30331-7100
(404) 662-3585
Mailing address
4143 RANDALL CT NW, ATLANTA, GA 30327-3711

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
207XS0106X
Orthopaedic Hand Surgery Physician
207XS0117X
Orthopaedic Surgery of the Spine Physician
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician

Other

Enumeration date
11/11/2021
Last updated
11/11/2021
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