Provider Demographics
NPI:1063110328
Name:ATLANTA HEALTH CENTER PC
Entity type:Organization
Organization Name:ATLANTA HEALTH CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:OHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:KOTT
Authorized Official - Suffix:
Authorized Official - Credentials:GENERAL PRACTIONER
Authorized Official - Phone:770-680-5740
Mailing Address - Street 1:4905 LAVISTA RD STE B
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-4409
Mailing Address - Country:US
Mailing Address - Phone:770-680-5740
Mailing Address - Fax:888-418-8738
Practice Address - Street 1:4905 LAVISTA RD STE B
Practice Address - Street 2:
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-4409
Practice Address - Country:US
Practice Address - Phone:770-680-5740
Practice Address - Fax:888-418-8738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-16
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty