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General NPI Number Information
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NPI Number | 1780737445
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Entity Type | Organization
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Legal Business Name | THE EMORY CLINIC, INC.
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1365 CLIFTON RD NE SUITE 2334
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City | ATLANTA
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State | GA
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Zip | 30322-1013
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Country | US
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Telephone | 404-778-3381
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Fax |
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Provider Business Mailing Address
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Address Line | 1365 CLIFTON RD NE SUITE 2334
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City | ATLANTA
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State | GA
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Zip | 30322-1013
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Country | US
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Telephone | 404-778-3381
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Fax |
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Authorized Official
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Title or Position | CHAIRMAN OF DEPARTMENT OF OTOLARYNG
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Name | DR. DOUGLAS MATTOX
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Credential | M.D.
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Telephone | 404-778-5329
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | AUD003726
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License Number State | GA
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