Healthcare Provider Details

I. General information

NPI: 1003554726
Provider Name (Legal Business Name): ALLHEALTH MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2022
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 HAMMOND DR STE 203
ATLANTA GA
30328
US

IV. Provider business mailing address

3359 BRIDLE RUN TRL NW
MARIETTA GA
30064-1785
US

V. Phone/Fax

Practice location:
  • Phone: 678-819-7777
  • Fax: 678-845-5855
Mailing address:
  • Phone: 678-819-7777
  • Fax: 678-845-5855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: LASHAUN ELLIOTT
Title or Position: OWNER
Credential: MD
Phone: 678-819-7777