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NPI Code Detail

MEDICARE: THE EMORY CLINIC INC

MEDICARE: THE EMORY CLINIC INC
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
1261QP3300XPain Clinic/Center
2261QA1903XAmbulatory Surgical Clinic/Center

General Provider Information

NPI Number : 1346403854
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE EMORY CLINIC INC
Provider Business Mailing Address
First Line : 1365 CLIFTON RD NE
Second Line :
City : ATLANTA
State : GA
Zip : 30322-1013
Country : US
Telephone Number : 404-778-5639
Fax Number :
Provider Business Practice Location Address
First Line : 21 ORTHO LN
Second Line :
City : ATLANTA
State : GA
Zip : 30329-2315
Country : US
Telephone Number : 404-778-5294
Fax Number :
Authorized Official
Title or Position : OPERATIONS ADMINISTRATOR
Name : MR. MIKE MASON
Credential :
Telephone Number : 404-778-5639
Provider Enumeration Date : 07/03/2008
Last Update Date : 10/13/2021

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Directions to “THE EMORY CLINIC INC ” Practice Location

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