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General NPI Number Information
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NPI Number | 1326002825
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Entity Type | Organization
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Legal Business Name | AGNES H HAN
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Dates
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Enumeration Date | 04/13/2006
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Last Update Date | 12/27/2010
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Provider Practice Location Address
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Address Line | 960 JOHNSON FERRY RD SUITE 515
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City | ATLANTA
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State | GA
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Zip | 30342-1611
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Country | US
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Telephone | 404-252-7703
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Fax | 404-252-8863
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Provider Business Mailing Address
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Address Line | 960 JOHNSON FERRY RD SUITE 515
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City | ATLANTA
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State | GA
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Zip | 30342-1611
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Country | US
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Telephone | 404-252-7703
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Fax | 404-252-8863
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Authorized Official
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Title or Position | OWNER
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Name | AGNES HAN
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Credential | MD
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Telephone | 404-252-7703
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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