Organization
CARROLLTON ORTHOPAEDIC CLINIC PC
Active
Other names
Carrollton Orthopaedic Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES GILBERT (CFO)
(727) 755-0693
Entity
Organization
Contact information
Practice address
812 S PARK ST STE 3, CARROLLTON, GA 30117-4412
(727) 755-0693
Mailing address
311 PARK PLACE BLVD, SUITE 500, CLEARWATER, FL 33759-4904
(727) 755-0693
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
038964
GA
3336C0002X
Clinic Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000104427
—
GA
01
—
2158456
PK
—
Enumeration date
03/01/2016
Last updated
03/04/2016
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