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General NPI Number Information
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NPI Number | 1629297478
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Entity Type | Organization
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Legal Business Name | GRADY MEMORIAL HOSPITAL CORPORATION
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 01/21/2025
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Provider Practice Location Address
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Address Line | 80 JESSE HILL JR DR, SE
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City | ATLANTA
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State | GA
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Zip | 30303-3050
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Country | US
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Telephone | 404-616-1746
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Fax | 404-616-2131
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Provider Business Mailing Address
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Address Line | 80 JESSE HILL JR DR, SE BOX 26159
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City | ATLANTA
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State | GA
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Zip | 30303-3050
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Country | US
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Telephone | 404-616-1746
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Fax | 404-616-2131
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Authorized Official
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Title or Position | EXEC VP, GENERAL COUNSEL
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Name | TIMOTHY JEFFERSON
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Credential |
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Telephone | 404-616-6180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number | 060-069
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License Number State | GA
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