Organization
POLARIS SPINE & NEUROSURGERY CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE HERR (CREDENTIALING SPECIALIST)
(608) 957-3025
Entity
Organization
Contact information
Practice address
1150 HAMMOND DR. BLDG E SUITE 400, ATLANTA, GA 30328
(404) 234-2753
(404) 255-6532
Mailing address
1150 HAMMOND DR. BLDG E SUITE 400, ATLANTA, GA 30328
(404) 234-2753
(404) 255-6532
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
225100000X
Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
055001482A
—
GA
Enumeration date
10/20/2006
Last updated
03/03/2022
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