Healthcare Provider Details

I. General information

NPI: 1235990896
Provider Name (Legal Business Name): WHOLE HEALTH ADVOCATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2024
Last Update Date: 06/06/2024
Certification Date: 06/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3080 HIGHLANDS PKWY SE
SMYRNA GA
30082-5181
US

IV. Provider business mailing address

3080 HIGHLANDS PKWY SE
SMYRNA GA
30082-5181
US

V. Phone/Fax

Practice location:
  • Phone: 404-445-8887
  • Fax: 866-525-8997
Mailing address:
  • Phone: 404-445-8887
  • Fax: 866-525-8997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. HARRY M LIGHTFOOT JR.
Title or Position: CO-FOUNDER AND CEO
Credential: MD
Phone: 404-326-0007