Provider Demographics
NPI:1447638226
Name:ORTHOATLANTA
Entity type:Organization
Organization Name:ORTHOATLANTA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:OCHAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-953-6929
Mailing Address - Street 1:771 OLD NORCROSS RD STE 390
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-4324
Mailing Address - Country:US
Mailing Address - Phone:678-957-0757
Mailing Address - Fax:678-957-0577
Practice Address - Street 1:771 OLD NORCROSS RD STE 390
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-4324
Practice Address - Country:US
Practice Address - Phone:678-957-0757
Practice Address - Fax:678-957-0577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-12
Last Update Date:2017-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty