Healthcare Provider Details

I. General information

NPI: 1003324187
Provider Name (Legal Business Name): AMERICAN PROFESSIONAL ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2018
Last Update Date: 08/23/2022
Certification Date: 08/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1136 CLEVELAND AVE STE 119
EAST POINT GA
30344-3618
US

IV. Provider business mailing address

PO BOX 745766
ATLANTA GA
30374-5766
US

V. Phone/Fax

Practice location:
  • Phone: 404-522-6569
  • Fax: 404-522-8265
Mailing address:
  • Phone: 770-350-0126
  • Fax: 770-515-9502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL L. MCCORD
Title or Position: CEO
Credential:
Phone: 770-350-0126