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General NPI Number Information
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NPI Number | 1538453444
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Entity Type | Organization
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Legal Business Name | K & L CARDIOVASCULAR
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Dates
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Enumeration Date | 06/08/2011
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Last Update Date | 06/08/2011
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Provider Practice Location Address
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Address Line | 494 BOULEVARD SE
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City | ATLANTA
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State | GA
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Zip | 30312-3426
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Country | US
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Telephone | 770-891-1465
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Fax | 404-343-2044
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Provider Business Mailing Address
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Address Line | 3955 PARHAM WAY
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City | ATLANTA
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State | GA
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Zip | 30349-1590
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Country | US
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Telephone | 770-891-1465
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Fax | 404-343-2044
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Authorized Official
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Title or Position | PHYSICIAN
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Name | MICHAEL B JONES
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Credential | M.D.
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Telephone | 770-891-1465
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 044638
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License Number State | GA
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