MEDICARE: DR. IRIS X TIAN DO

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
1	208100000X	Physical Medicine & Rehabilitation Physician	99722	GA

General Provider Information

NPI Number	:	1356799043
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. IRIS X TIAN DO

Provider Business Mailing Address
First Line	:	275 CARPENTER DR STE 303
Second Line	:
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30328-4911
Country	:	US
Telephone Number	:	470-570-4341
Fax Number	:	404-446-4136

Provider Business Practice Location Address
First Line	:	275 CARPENTER DR STE 303
Second Line	:
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30328-4911
Country	:	US
Telephone Number	:	470-570-4341
Fax Number	:	404-446-4136

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2016
Last Update Date	:	07/19/2025

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Directions to “ DR. IRIS X TIAN DO” Practice Location

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