Healthcare Provider Details

I. General information

NPI: 1821113556
Provider Name (Legal Business Name): MED HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4780 ASHFORD DUNWOODY ROAD STE A418
ATLANTA GA
30338-5504
US

IV. Provider business mailing address

4780 ASHFORD DUNWOODY ROAD STE A418
ATLANTA GA
30338-5504
US

V. Phone/Fax

Practice location:
  • Phone: 866-986-2983
  • Fax: 866-433-1426
Mailing address:
  • Phone: 866-986-2983
  • Fax: 866-433-1426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number031857
License Number StateGA

VIII. Authorized Official

Name: ROBERT E WINDSOR
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 866-986-2983