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General NPI Number Information
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NPI Number | 1578098240
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Entity Type | Individual
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Provider Name | IAN CHRISTOPHER QUINN D.O.
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Gender | Male
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Dates
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Enumeration Date | 05/01/2017
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Last Update Date | 06/02/2023
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Provider Practice Location Address
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Address Line | 1270 FRIENDSHIP RD.
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City | BRASELTON
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State | GA
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Zip | 30517-3051
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Country | US
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Telephone | 678-207-4050
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Fax | 678-207-4051
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Provider Business Mailing Address
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Address Line | PO BOX 658
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City | GAINESVILLE
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State | GA
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Zip | 30503-0658
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Country | US
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Telephone | 770-718-1122
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Fax | 770-533-4786
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 89636
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2020-02252
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 2020-02252
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 89636
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License Number State | GA
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