Organization
GEORGIA SPINE SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIGUEL JIMENEZ MD (PRESIDENT)
(678) 838-6600
Entity
Organization
Contact information
Practice address
3903 S COBB DR SE, SUITE 105, SMYRNA, GA 30080-6342
(678) 838-6600
(770) 334-1477
Mailing address
3903 SOUTH COBB DR, SUITE 105, SMYRNA, GA 30080
(678) 838-6600
(770) 438-1477
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
615972752B
—
GA
05
—
805775515A
—
GA
Enumeration date
07/04/2006
Last updated
04/17/2009
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