Organization
GEORGIA SPINE SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIGUEL A JIMENEZ M.D. (PRESIDENT)
(678) 838-6600
Entity
Organization
Contact information
Practice address
11 MAYBELLE ST, CARTERSVILLE, GA 30120-3615
(678) 838-6600
(678) 838-6602
Mailing address
3903 S COBB DR SE, SUITE 110, SMYRNA, GA 30080-6342
(678) 838-6600
(678) 838-6602
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
052966
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
230782561A
—
GA
05
—
615972752A
—
GA
05
—
805775515A
—
GA
Enumeration date
05/10/2007
Last updated
03/25/2009
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