Healthcare Provider Details

I. General information

NPI: 1205748720
Provider Name (Legal Business Name): HEALTH CENTER MSO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1375 PEACHTREE ST NE STE 185S
ATLANTA GA
30309-3173
US

IV. Provider business mailing address

1375 PEACHTREE ST NE STE 185S
ATLANTA GA
30309-3173
US

V. Phone/Fax

Practice location:
  • Phone: 877-254-3207
  • Fax: 877-254-3207
Mailing address:
  • Phone: 877-254-3207
  • Fax: 877-254-3207

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number
License Number State

VIII. Authorized Official

Name: DR. BRADLEY SMITH
Title or Position: DIRECTOR
Credential: MD
Phone: 877-254-3207