Healthcare Provider Details

I. General information

NPI: 1023955689
Provider Name (Legal Business Name): PHYSICIAN'S EDGE MEDICAL COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3230 WOOD VALLEY RD NW
ATLANTA GA
30327-1514
US

IV. Provider business mailing address

3230 WOOD VALLEY RD NW
ATLANTA GA
30327-1514
US

V. Phone/Fax

Practice location:
  • Phone: 404-275-5435
  • Fax:
Mailing address:
  • Phone: 404-275-5435
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: STEVEN ELLIOTT
Title or Position: OWNER
Credential: MD
Phone: 404-275-5435