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General NPI Number Information
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NPI Number | 1700036050
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Entity Type | Organization
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Legal Business Name | GREATER ATLANTA NEUROSURGERY PC
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Dates
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Enumeration Date | 09/23/2008
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Last Update Date | 09/23/2008
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Provider Practice Location Address
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Address Line | 550 PEACHTREE ST NE SUITE 1577
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City | ATLANTA
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State | GA
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Zip | 30308-2247
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Country | US
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Telephone | 404-522-3330
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Fax | 404-522-3332
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Provider Business Mailing Address
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Address Line | PO BOX 71406
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City | ALBANY
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State | GA
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Zip | 31708-1406
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Country | US
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Telephone | 404-522-3330
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Fax | 404-522-3332
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL THOMAS STECHISON
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Credential | MD PHD
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Telephone | 404-522-3330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State |
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