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General NPI Number Information
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NPI Number | 1366727091
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Entity Type | Organization
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Legal Business Name | HYPERSPHERE
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Dates
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Enumeration Date | 10/13/2011
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Last Update Date | 10/13/2011
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Provider Practice Location Address
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Address Line | 550 PEACHTREE ST NE SUITE 3300
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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 | 404-686-2289
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Fax |
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Provider Business Mailing Address
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Address Line | 2752 FAIRBURN RD
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City | DOUGLASVILLE
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State | GA
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Zip | 30135-2912
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Country | US
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Telephone | 770-920-0610
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | WILLIAM SCOTT ALEXANDER II
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Credential | M.D.
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Telephone | 770-920-0610
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207PE0005X
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Taxonomy Name | Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
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License Number | 22709
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License Number State | GA
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