Provider Demographics
NPI:1871776922
Name:ORTHOPAEDICS OF ATLANTA, PC
Entity type:Organization
Organization Name:ORTHOPAEDICS OF ATLANTA, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:WADIH
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:ABSI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-768-1133
Mailing Address - Street 1:4485 S COBB DR SE STE 100
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-6957
Mailing Address - Country:US
Mailing Address - Phone:404-768-1133
Mailing Address - Fax:404-768-0309
Practice Address - Street 1:4485 S COBB DR SE STE 100
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-6957
Practice Address - Country:US
Practice Address - Phone:404-768-1133
Practice Address - Fax:404-768-0309
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORTHOPAEDICS OF ATLANTA PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-12
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA044661302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
174249OtherCOVENTRY HEALTH
7102000GA30344OtherBLUE CROSS OF MI
GA7439027OtherRETNA
0902271OtherUNITED HEALTH CARE
361770600OtherDEPT OF LABOR
200044916OtherRAILROAD MEDICARE
52702670005OtherBLUE CROSS OF GA
309294OtherWELL CARE
GA4190057OtherCIGNA
200044916OtherRAILROAD MEDICARE
20BBFLZMedicare PIN