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Organization

GEORGIA SPINE AND BRAIN, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
OMAR JIMENEZ MD (OWNER)
(678) 838-6600
Entity
Organization

Contact information

Practice address
1676 MULKEY RD, SUITE A, AUSTELL, GA 30106-1170
(678) 838-6600
(678) 838-6602
Mailing address
1676 MULKEY RD, SUITE A, AUSTELL, GA 30106-1170
(678) 838-6600
(678) 838-6602

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
GRP4690
MEDICARE GRP ID
GA
Enumeration date
07/04/2006
Last updated
08/22/2020
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