Healthcare Provider Details

I. General information

NPI: 1871760231
Provider Name (Legal Business Name): ATLANTA CHILDREN'S ENT, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2008
Last Update Date: 05/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 OLD MILTON PKWY SUITE C-465
ALPHARETTA GA
30005-3707
US

IV. Provider business mailing address

3400 OLD MILTON PKWY SUITE C-465
ALPHARETTA GA
30005-3707
US

V. Phone/Fax

Practice location:
  • Phone: 770-777-1100
  • Fax: 770-751-9089
Mailing address:
  • Phone: 770-777-1100
  • Fax: 770-751-9089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YP0228X
TaxonomyPediatric Otolaryngology Physician
License Number035352
License Number StateGA

VIII. Authorized Official

Name: DR. ANN K WHITE
Title or Position: PRESIDENT AND OWNER
Credential: M.D.
Phone: 770-777-1100