Healthcare Provider Details

I. General information

NPI: 1215846829
Provider Name (Legal Business Name): FENIX MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3547 PEACHTREE INDUSTRIAL BLVD STE 9-10
DULUTH GA
30096-1419
US

IV. Provider business mailing address

3547 PEACHTREE INDUSTRIAL BLVD STE 9-10
DULUTH GA
30096-1419
US

V. Phone/Fax

Practice location:
  • Phone: 770-901-7100
  • Fax:
Mailing address:
  • Phone: 770-901-7100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ERIC ALLEN
Title or Position: COO
Credential:
Phone: 404-538-4945