Georgia Sports Medicine, Llc

LBN: Georgia Sports Medicine, Llc
Georgia Sports Medicine, Llc is an health care organization with primary practice located at 6340 Sugarloaf Pkwy Ste 375, Duluth GA 30097-4333. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as the primary health care specialty. Georgia Sports Medicine, Llc can be contacted via phone (770) 814-2223, or through Cullen, Mark via phone (770) 814-2223.

Contact Information

Primary practice address
6340 Sugarloaf Pkwy Ste 375 Duluth GA 30097-4333
Phone: (770) 814-2223
Fax: (770) 814-2232
Website:
Map and Directions
Authorized official contact:
Name: Cullen, Mark Doctor of Medicine (MD)
Phone: (770) 814-2223

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X 043191 Georgia

Profile Details

NPI number 1710160601
LBN Legal business name Georgia Sports Medicine, Llc
DBA Doing business as
Authorized official Cullen, Mark Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Dec 13th, 2007
Last updated Oct 7th, 2011 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710160601 NPPES
Georgia Other GRP5069 MEDICARE GROUP ID

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