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NPI Code Detail

MEDICARE: NORTH ATLANTA OB GYN 2 LLC

MEDICARE: NORTH ATLANTA OB GYN 2 LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology Physician

General Provider Information

NPI Number : 1265562961
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTH ATLANTA OB GYN 2 LLC
Provider Business Mailing Address
First Line : PO BOX 468329
Second Line :
City : ATLANTA
State : GA
Zip : 31146-8329
Country : US
Telephone Number : 404-943-0205
Fax Number :
Provider Business Practice Location Address
First Line : 5780 PEACHTREE DUNWOODY RD NE
Second Line : SUITE 295
City : ATLANTA
State : GA
Zip : 30342-1554
Country : US
Telephone Number : 404-943-0205
Fax Number :
Authorized Official
Title or Position : LEAD
Name : ALICIA HOLDEN
Credential : ACCOUNTING
Telephone Number : 404-943-0205
Provider Enumeration Date : 03/06/2007
Last Update Date : 08/22/2020

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Directions to “NORTH ATLANTA OB GYN 2 LLC ” Practice Location

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