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General NPI Number Information
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NPI Number | 1578740882
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Entity Type | Organization
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Legal Business Name | EMORY UNIVERSITY EMERGENCY MEDICINE
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Dates
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Enumeration Date | 01/29/2008
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Last Update Date | 01/29/2008
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Provider Practice Location Address
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Address Line | 49 JESSE HILL JR DR SE
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City | ATLANTA
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State | GA
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Zip | 30303-3049
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Country | US
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Telephone | 404-616-6673
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Fax |
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Provider Business Mailing Address
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Address Line | 1823 CALIBRE WOODS DR NE
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City | ATLANTA
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State | GA
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Zip | 30329-3956
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | RESIDENT PHYSICIAN
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Name | MS. EBONY RUCKER
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Credential |
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Telephone | 313-942-5660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | 861500
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License Number State | GA
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