Healthcare Provider Details

I. General information

NPI: 1295315802
Provider Name (Legal Business Name): TOPPLE DIAGNOSTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2021
Last Update Date: 03/25/2022
Certification Date: 03/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 CENTURY PKWY NE STE 260
ATLANTA GA
30345-3103
US

IV. Provider business mailing address

2200 CENTURY PKWY NE STE 260
ATLANTA GA
30345-3103
US

V. Phone/Fax

Practice location:
  • Phone: 404-267-1818
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0301X
TaxonomyBrain Injury Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BRENT JONES
Title or Position: CEO
Credential:
Phone: 404-316-4136