Canton Market Place Medical, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

CANTON MARKET PLACE MEDICAL, LLC

Practice address

2050 Cumming Hwy
Suite 100
Canton, GA 30115-2314

Phone

(770) 674-6366

NPI assigned

Dec 4, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. David Odorisio, D.C,

Title

Owner

Phone

(770) 674-6366

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1449187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449187200000",
    "number": "1770958571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 W MAIN ST",
            "address_2": "SUITE 204",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301142757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 CUMMING HWY",
            "address_2": "SUITE 100",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301152314",
            "telephone_number": "770-674-6366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANTON MARKET PLACE MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-04",
        "last_updated": "2015-12-04",
        "status": "A",
        "authorized_official_last_name": "ODORISIO",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-674-6366",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C,"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Canton, GA
• Providers in Canton, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.