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General NPI Number Information
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NPI Number | 1285815258
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Entity Type | Organization
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Legal Business Name | ATLANTA UROLOGICAL GROUP, P.C.
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Dates
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Enumeration Date | 11/19/2007
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Last Update Date | 01/16/2008
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Provider Practice Location Address
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Address Line | 285 BOULEVARD NE STE 215
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City | ATLANTA
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State | GA
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Zip | 30312-4205
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Country | US
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Telephone | 404-524-5082
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Fax | 404-521-2977
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Provider Business Mailing Address
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Address Line | 285 BOULEVARD NE STE 215
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City | ATLANTA
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State | GA
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Zip | 30312-4205
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Country | US
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Telephone | 404-524-5082
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Fax | 404-521-2977
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Authorized Official
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Title or Position | PRESIDENT
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Name | THOMAS W SCHOBORG
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Credential | M.D.
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Telephone | 404-524-5082
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 016834
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License Number State | GA
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