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Carrollton Orthopaedic Clinic, PC

Organization Active NPI Orthopaedic Surgery Physician · Villa Rica, GA

NPI 1154728871 · NPPES record last updated Nov 24, 2014

Key facts

NPI
1154728871
Entity type
Organization (NPI type 2)
Primary specialty
Orthopaedic Surgery Physician 207X00000X
Legal business name
CARROLLTON ORTHOPAEDIC CLINIC, PC
Practice address
705 Dallas Hwy
Suite 301
Villa Rica, GA 30180-1247
Phone
(678) 601-5220
NPI assigned
Nov 24, 2014
Organization subpart
Yes
Parent organization (as reported)
CARROLLTON ORTHOPAEDIC CLINIC, PC

Authorized official

Name
Dr. Ralph Fleck
Title
MD
Phone
(678) 601-5220

Corporate family (same tax ID) 4

Organizations that report the same tax identification number in the National Provider Directory.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2096066Villa Rica Orthopaedics
705 Dallas Hwy, Suite 301, Villa Rica, GA 30180		Certificate of waiverMay 13, 2027

National Provider Directory

Tax ID family
Carrollton Ortho Clinic (5 organizations share this tax ID)
Part of
Carrollton Ortho Clinic

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 207X00000X Yes

Addresses

Primary practice location

705 Dallas Hwy
Suite 301
Villa Rica, GA 30180-1247

Mailing address

150 Clinic Ave
Suite 101
Carrollton, GA 30117-4401
Phone (678) 601-5220

Other names

  • Villa Rica Orthopaedics Doing business as

Other providers in Villa Rica, GA

All providers in Villa Rica, GA · Orthopaedic Surgery Physician in Georgia

Sources for this page

Verify at the official NPI Registry.