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NPI Code Detail

MEDICARE: PEACHTREE LABORATORY ASSOCIATES PC

MEDICARE: PEACHTREE LABORATORY ASSOCIATES PC
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
1291U00000XClinical Medical LaboratoryGA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1588623110
Entity Type Code : Organization
Provider Name (Legal Business Name) : PEACHTREE LABORATORY ASSOCIATES PC
Provider Business Mailing Address
First Line : PO BOX 491028
Second Line :
City : LAWRENCEVILLE
State : GA
Zip : 30049-0053
Country : US
Telephone Number : 404-605-2054
Fax Number : 404-609-6766
Provider Business Practice Location Address
First Line : 1984 PEACHTREE RD NW
Second Line :
City : ATLANTA
State : GA
Zip : 30309-1298
Country : US
Telephone Number : 800-288-8325
Fax Number : 404-609-6766
Authorized Official
Title or Position : SECRETARY TREASURER
Name : MARK H DUPUIS
Credential : MD
Telephone Number : 404-605-2054
Provider Enumeration Date : 03/22/2006
Last Update Date : 10/06/2022

Similar Medicare Providers

1447252713 — DR. SEAN LEIGH COY MD
Practice Location Address:
1984 PEACHTREE RD NW
ATLANTA, GA
30309-1298
Practice Phone: 404-351-1745
Practice Fax:
1407856594 — PIEDMONT ANESTHESIA ASSOCIATES, L.L.C
Practice Location Address:
1984 PEACHTREE ROAD NW , SUITE 515
ATLANTA, GA
30309-1298
Practice Phone: 404-351-1745
Practice Fax:
1144220245 — FAYETTE COMMUNITY ANESTHESIA
Practice Location Address:
1984 PEACHTREE RD NW , SUITE 515
ATLANTA, GA
30309-1298
Practice Phone: 404-351-1745
Practice Fax:
1033104583 — BESSIE B CHEN MD
Practice Location Address:
1984 PEACHTREE RD NW , SUITE 515
ATLANTA, GA
30309-1298
Practice Phone: 404-351-1745
Practice Fax:
1922093152 — STEPHEN C GOLDEN
Practice Location Address:
1984 PEACHTREE RD NW , SUITE 515
ATLANTA, GA
30309-1298
Practice Phone: 404-351-1745
Practice Fax:
1831182518 — JONATHAN CLAYTON MD
Practice Location Address:
1255 HIGHWAY 54 W
FAYETTEVILLE, GA
30214-4526
Practice Phone: 404-351-1745
Practice Fax:

Directions to “PEACHTREE LABORATORY ASSOCIATES PC ” Practice Location

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