Healthcare Provider Details

I. General information

NPI: 1952385254
Provider Name (Legal Business Name): LOUIS A DINATTI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2005
Last Update Date: 04/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 RIVERBEND DR SW
ROME GA
30161-6066
US

IV. Provider business mailing address

20 RIVERBEND DR SW
ROME GA
30161-6066
US

V. Phone/Fax

Practice location:
  • Phone: 706-295-0070
  • Fax: 706-235-1618
Mailing address:
  • Phone: 706-295-0070
  • Fax: 706-235-1618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number049774
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number049774
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: