Healthcare Provider Details

I. General information

NPI: 1033112198
Provider Name (Legal Business Name): ALAN I SEGAL M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 JOHNSON FERRY RD NE STE 200
ATLANTA GA
30342-1631
US

IV. Provider business mailing address

9700 HILLSIDE DR
ROSWELL GA
30076-2827
US

V. Phone/Fax

Practice location:
  • Phone: 404-943-0900
  • Fax:
Mailing address:
  • Phone: 678-461-8039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number0843
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: