Provider Demographics
NPI:1043070014
Name:REGENERATIVE ORTHOPAEDICS AND SPINE INSTITUTE, PC
Entity type:Organization
Organization Name:REGENERATIVE ORTHOPAEDICS AND SPINE INSTITUTE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:G
Authorized Official - Last Name:PLOSKAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-892-0300
Mailing Address - Street 1:135 N. PARK PLACE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281
Mailing Address - Country:US
Mailing Address - Phone:770-892-0300
Mailing Address - Fax:470-878-1495
Practice Address - Street 1:1819 PEACHTREE STREET
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309
Practice Address - Country:US
Practice Address - Phone:770-892-0300
Practice Address - Fax:470-878-1495
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REGENERATIVE ORTHOPAEDICS AND SPINE INSTITUTE PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-03-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies