| Atlanta Osteoarthritis Center LLC | |
|
2550 Windy Hill Rd Se Ste 308 Marietta GA 30067-8655 | |
| (404) 800-8533 | |
| (470) 600-4481 |
| Full Name | Atlanta Osteoarthritis Center LLC |
|---|---|
| Speciality | General Practice |
| Location | 2550 Windy Hill Rd Se Ste 308, Marietta, Georgia |
| Authorized Official Name and Position | Phillip Wofford (DIRECTOR) |
| Authorized Official Contact | 4048008533 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Atlanta Osteoarthritis Center LLC 2550 Windy Hill Rd Se Ste 308 Marietta GA 30067-8655 Ph: (404) 800-8533 | Atlanta Osteoarthritis Center LLC 2550 Windy Hill Rd Se Ste 308 Marietta GA 30067-8655 Ph: (404) 800-8533 |
| NPI Number | 1548892458 |
|---|---|
| Provider Enumeration Date | 02/08/2020 |
| Last Update Date | 06/02/2023 |
| Certification Date | 06/02/2023 |
| Medicare PECOS PAC ID | 2567893357 |
|---|---|
| Medicare Enrollment ID | O20200814002136 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548892458 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Secondary |
| 2081P2900X | Physical Medicine & Rehabilitation - Pain Medicine | () | Secondary |
| 208D00000X | General Practice | () | Primary |
| Provider Name | Richard L Manrique |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548299332 PECOS PAC ID: 5890783583 Enrollment ID: I20040505000507 |
| Provider Name | Shreedhar N Nagnur |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538168968 PECOS PAC ID: 7618936188 Enrollment ID: I20080603000264 |
| Provider Name | Michelle Austin Robinson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1538585799 PECOS PAC ID: 5698094092 Enrollment ID: I20150506002646 |
| Provider Name | Richard Everett Lorenz |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1568567642 PECOS PAC ID: 9133545502 Enrollment ID: I20200814002849 |
| Provider Name | Jaclyn Rogers |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1972868651 PECOS PAC ID: 7315961612 Enrollment ID: I20210408002244 |
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