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General NPI Number Information
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NPI Number | 1598181943
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Entity Type | Individual
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Provider Name | VIKAS NATH MD
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Gender | Male
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Dates
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Enumeration Date | 03/10/2014
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Last Update Date | 05/23/2022
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Provider Practice Location Address
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Address Line | 200 INDUSTRIAL BLVD
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City | DUBLIN
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State | GA
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Zip | 31021-2981
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Country | US
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Telephone | 478-274-3825
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Fax | 478-274-3254
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Provider Business Mailing Address
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Address Line | PO BOX 741087
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City | ATLANTA
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State | GA
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Zip | 30374-1087
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Country | US
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Telephone | 478-464-5567
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Fax | 478-751-0455
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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 | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 036.141954
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 90143
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License Number State | GA
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