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General NPI Number Information
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NPI Number | 1215079736
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Entity Type | Individual
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Provider Name | CARLOS ALBERTO ESCOBAR NP-C
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Gender | Male
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 03/26/2018
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Provider Practice Location Address
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Address Line | 6460 HIGHWAY 92 STE 200
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City | ACWORTH
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State | GA
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Zip | 30102-2998
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Country | US
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Telephone | 770-880-4517
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Fax |
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Provider Business Mailing Address
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Address Line | 6460 HIGHWAY 92 STE 200
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City | ACWORTH
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State | GA
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Zip | 30102-2998
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Country | US
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Telephone | 770-880-4517
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | RN225443
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN225443
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License Number State | GA
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