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General NPI Number Information
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NPI Number | 1598805707
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Entity Type | Organization
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Legal Business Name | GEORGIA HEART AND LUNG ASSOCIATES PC
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 05/01/2009
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Provider Practice Location Address
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Address Line | 315 BOULEVARD NE 310
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City | ATLANTA
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State | GA
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Zip | 30312-1200
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Country | US
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Telephone | 404-223-5551
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Fax | 404-223-0910
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Provider Business Mailing Address
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Address Line | 315 BOULEVARD NE 310
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City | ATLANTA
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State | GA
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Zip | 30312-1200
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Country | US
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Telephone | 404-223-5551
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Fax | 404-223-0910
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Authorized Official
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Title or Position | PRESIDENT OWNER
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Name | DR. MICHAEL VINCENT SMITH
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Credential | MD
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Telephone | 404-223-5551
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 032056
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License Number State | GA
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