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General NPI Number Information
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NPI Number | 1902952625
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Entity Type | Organization
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Legal Business Name | RL BROWN JR GRADY HEALTH CENTER AT HARTSFIELD JACKSON AIRPORT
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6000 NORTH TERMINAL PARKWAY ATRIUM SUITE 375
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City | ATLANTA
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State | GA
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Zip | 30320
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Country | US
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Telephone | 404-616-6000
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Fax | 404-768-3990
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Provider Business Mailing 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 | 30303-3031
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Country | US
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Telephone | 404-616-6000
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Fax | 404-768-3990
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. JOSEPH E TAYLOR
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Credential |
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Telephone | 404-616-4930
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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 | 060-069
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License Number State | GA
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