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Organization

ORTHOPEDIC SURGEONS OF GEORGIA LLC

Active
Parent organization
ORTHOPEDIC SURGEONS OF GEORGIA, LLC
Other names
Optim Orthopedics
Organization subpart
Yes

Provider details

NPI number
Legal business name
ORTHOPEDIC SURGEONS OF GEORGIA, LLC
Authorized official
MRS. LAVONDA L. CRAVEY (CONTROLLER)
(912) 383-5600
Entity
Organization

Contact information

Practice address
2015 ALICE ST, WAYCROSS, GA 31501-6209
(912) 548-0590
(912) 644-5260
Mailing address
210 E DERENNE AVE ATTN PROVIDER ENROLLMENT, SAVANNAH, GA 31405-6736
(912) 644-5300
(912) 644-5260

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary

Other

Enumeration date
02/13/2013
Last updated
04/09/2015
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