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General NPI Number Information
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NPI Number | 1699737445
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Entity Type | Organization
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Legal Business Name | GRADY HEALTH SYSTEM
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Dates
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Enumeration Date | 04/06/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 80 JESSE HILL JR DRIVE HUGHES SPALDING CHILDREN'S HOSPITAL
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City | ATLANTA
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State | GA
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Zip | 30303
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Country | US
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Telephone | 404-616-5650
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Fax |
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Provider Business Mailing Address
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Address Line | 5619 VININGS RETREAT PASS SW
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City | MABLETON
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State | GA
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Zip | 30126-2569
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Country | US
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Telephone | 770-948-1834
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Fax |
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Authorized Official
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Title or Position | DIRECTOR EMERGENCY SERVICES
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Name | MRS. NAGHMA KHAN
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Credential | M.D.
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Telephone | 404-785-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | 140352
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License Number State | GA
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