Organization
SPINE AND ORTHOPEDICS OF ATLANTA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAMIEN DOUTE MD (OWNER/PHYSICIAN)
(470) 440-5848
Entity
Organization
Contact information
Practice address
1462 MONTREAL RD STE 218, TUCKER, GA 30084
(470) 294-0863
(470) 294-0889
Mailing address
1462 MONTREAL RD STE 218, TUCKER, GA 30084-6931
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
728513163A
—
GA
Enumeration date
10/01/2015
Last updated
09/06/2018
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