Organization
PEDIATRIC ORTHOPAEDIC ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELLE GULLEY (CEO)
(404) 321-9900
Entity
Organization
Contact information
Practice address
6 EXECUTIVE PARK DR NE, SUITE 10, ATLANTA, GA 30329-2221
(404) 321-9900
(404) 321-4460
Mailing address
6 EXECUTIVE PARK DR NE, SUITE 10, ATLANTA, GA 30329-2221
(404) 321-9900
(404) 321-4460
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
00010591
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000053237C
—
GA
05
—
000119578E
—
GA
05
—
000612598F
—
GA
05
—
000867787A
—
GA
05
—
000944523A
—
GA
Enumeration date
06/13/2008
Last updated
02/03/2012
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