Healthcare Provider Details

I. General information

NPI: 1053869578
Provider Name (Legal Business Name): EMORY UNIVERSITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2016
Last Update Date: 09/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1364 CLIFTON RD NE
ATLANTA GA
30322-1064
US

IV. Provider business mailing address

1364 CLIFTON RD NE
ATLANTA GA
30322-1064
US

V. Phone/Fax

Practice location:
  • Phone: 404-727-0093
  • Fax:
Mailing address:
  • Phone: 404-727-0093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: NATALIE RAE JENKS
Title or Position: ANESTHESIOLOGIST ASSISTANT
Credential: MMSC
Phone: 505-280-4188