Organization
NORTH GEORGIA SPINE AND INTERVENTIONAL ORTHOPEDICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SALLU JABATI (MEDICAL DIRECTOR)
(678) 559-4526
Entity
Organization
Contact information
Practice address
1897 HIGHWAY 211 NW STE 105, HOSCHTON, GA 30548-3514
(706) 253-3341
(770) 307-0306
Mailing address
1897 HIGHWAY 211 NW STE 105, HOSCHTON, GA 30548-3514
(706) 253-3341
(770) 307-0306
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
058527
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1235104431
NPI INDIVIDUAL
—
05
—
712681970B
—
GA
Enumeration date
06/29/2010
Last updated
06/30/2010
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