Basic Information
| Provider Information | |||||||||
| NPI: | 1477652139 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SPECIALTY ORTHOPAEDICS, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1240 JESSE JEWELL PKWY SE | ||||||||
| Address2: | STE 300 | ||||||||
| City: | GAINESVILLE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 305013862 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7705327202 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1240 JESSE JEWELL PKWY SE | ||||||||
| Address2: | STE 300 | ||||||||
| City: | GAINESVILLE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 305013862 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7705327202 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/21/2006 | ||||||||
| LastUpdateDate: | 06/09/2021 | ||||||||
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| AuthorizedOfficialLastName: | WEISS | ||||||||
| AuthorizedOfficialFirstName: | WILLIAM | ||||||||
| AuthorizedOfficialMiddleName: | DAVID | ||||||||
| AuthorizedOfficialTitleorPosition: | PROVIDER | ||||||||
| AuthorizedOfficialTelephone: | 7705357160 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 06/09/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.