Healthcare Provider Details

I. General information

NPI: 1639676638
Provider Name (Legal Business Name): EMILY GRACE POINDEXTER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2018
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 JOHNSON FERRY RD
ATLANTA GA
30342-1605
US

IV. Provider business mailing address

1217 KENDRICK RD NE
BROOKHAVEN GA
30319-2819
US

V. Phone/Fax

Practice location:
  • Phone: 404-785-2273
  • Fax: 404-785-9168
Mailing address:
  • Phone: 317-366-9243
  • Fax: 404-785-5846

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number91720
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License Number91720
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number39077
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: