Healthcare Provider Details

I. General information

NPI: 1780875674
Provider Name (Legal Business Name): YAMEIKA A HEAD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2007
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

919 EAGLES LANDING PKWY STE 919
STOCKBRIDGE GA
30281-5011
US

IV. Provider business mailing address

919 EAGLES LANDING PKWY STE 919
STOCKBRIDGE GA
30281-5011
US

V. Phone/Fax

Practice location:
  • Phone: 470-974-3243
  • Fax: 470-974-3243
Mailing address:
  • Phone: 470-974-3243
  • Fax: 470-974-3243

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number63869
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number200976
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: