MEDICARE: PINNACLE NEUROLOGY 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
1	2084N0400X	Neurology Physician

General Provider Information

NPI Number	:	1578491650
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PINNACLE NEUROLOGY LLC

Provider Business Mailing Address
First Line	:	1320 RIDGEFIELD DR
Second Line	:
City	:	ROSWELL
State	:	GA
Zip	:	30075-4119
Country	:	US
Telephone Number	:	404-698-9671
Fax Number	:

Provider Business Practice Location Address
First Line	:	519 JOHNSON FERRY RD BLDG B
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30068-4641
Country	:	US
Telephone Number	:	404-698-9671
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ELIZABETH HANNAH FABIAN
Credential	:
Telephone Number	:	404-698-9671

Provider Enumeration Date	:	05/11/2026
Last Update Date	:	05/11/2026

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