=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285681361
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NORTH ATLANTA CARDIOVASCULAR ASSOCIATES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/27/2006
-----------------------------------------------------
Last Update Date | 11/27/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 975 JOHNSON FERRY RD NE SUITE 340
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30342-1619
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-256-0121
-----------------------------------------------------
Fax | 404-843-0355
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 975 JOHNSON FERRY RD NE SUITE 340
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30342-1619
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-256-0121
-----------------------------------------------------
Fax | 404-843-0355
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. ALAN TARANTO
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 404-256-0121
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------