Healthcare Provider Details

I. General information

NPI: 1265502892
Provider Name (Legal Business Name): NEPHROLOGY CONSULTANTS OF GEORGIA, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 05/24/2022
Certification Date: 05/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 COLLIER RD NW SUITE 290
ATLANTA GA
30309-1709
US

IV. Provider business mailing address

275 COLLIER RD NW SUITE 290
ATLANTA GA
30309-1709
US

V. Phone/Fax

Practice location:
  • Phone: 404-352-3300
  • Fax: 404-477-2276
Mailing address:
  • Phone: 404-352-3300
  • Fax: 404-477-2276

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: MRS. FRAN MACONI
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 404-352-3300