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General NPI Number Information
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NPI Number | 1154643096
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Entity Type | Organization
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Legal Business Name | ATLANTA GASTROENTEROLOGY ASSOCIATES
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Dates
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Enumeration Date | 02/19/2010
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Last Update Date | 02/19/2010
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Provider Practice Location Address
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Address Line | 550 PEACHTREE ST NE SUITE 1600
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City | ATLANTA
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State | GA
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Zip | 30308-2208
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Country | US
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Telephone | 404-881-1094
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Fax |
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Provider Business Mailing Address
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Address Line | 550 PEACHTREE ST NE SUITE 1600
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City | ATLANTA
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State | GA
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Zip | 30308-2208
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Country | US
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Telephone | 404-881-1094
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | STEVEN J MORRIS
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Credential | M.D.
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Telephone | 404-881-1094
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 005773
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License Number State | GA
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