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NPI Code Detail

MEDICARE: EMORY MEDICAL CARE FOUNDATION

MEDICARE: EMORY MEDICAL CARE FOUNDATION
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
1207LA0401XAddiction Medicine (Anesthesiology) Physician
2207LC0200XCritical Care Medicine (Anesthesiology) Physician
3207LH0002XHospice and Palliative Medicine (Anesthesiology) Physician
4207LP2900XPain Medicine (Anesthesiology) Physician
5207LP3000XPediatric Anesthesiology Physician
6207L00000XAnesthesiology Physician

General Provider Information

NPI Number : 1952567463
Entity Type Code : Organization
Provider Name (Legal Business Name) : EMORY MEDICAL CARE FOUNDATION
Provider Business Mailing Address
First Line : 101 W PONCE DE LEON AVE
Second Line :
City : DECATUR
State : GA
Zip : 30030-2542
Country : US
Telephone Number : 404-778-5014
Fax Number : 404-778-4819
Provider Business Practice Location Address
First Line : 80 JESSE HILL JR DR SE
Second Line :
City : ATLANTA
State : GA
Zip : 30303-3031
Country : US
Telephone Number : 404-778-5014
Fax Number : 404-778-4819
Authorized Official
Title or Position : DIRECTOR
Name : DOROTHY COOK-WALTER
Credential :
Telephone Number : 404-778-2144
Provider Enumeration Date : 08/04/2008
Last Update Date : 08/04/2008

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Directions to “EMORY MEDICAL CARE FOUNDATION ” Practice Location

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