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General NPI Number Information
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NPI Number | 1962832444
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Entity Type | Organization
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Legal Business Name | GEORGIA NEONATOLOGY LLC
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Dates
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Enumeration Date | 11/19/2013
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Last Update Date | 11/19/2013
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Provider Practice Location Address
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Address Line | 124 BRADFORD DR
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City | MACON
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State | GA
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Zip | 31210-1267
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Country | US
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Telephone | 706-614-1964
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Fax |
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Provider Business Mailing Address
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Address Line | 124 BRADFORD DR
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City | MACON
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State | GA
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Zip | 31210-1267
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Country | US
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Telephone | 706-614-1964
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ATUL KHURANA
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Credential |
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Telephone | 706-614-1964
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 38531
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License Number State | GA
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