Provider Demographics
NPI:1194879841
Name:MIDTOWN MEDICAL ASSOCIATES, LLC
Entity type:Organization
Organization Name:MIDTOWN MEDICAL ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DOT
Authorized Official - Middle Name:
Authorized Official - Last Name:REEVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-215-6525
Mailing Address - Street 1:550 PEACHTREE ST NE
Mailing Address - Street 2:SUITE 1230
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-2238
Mailing Address - Country:US
Mailing Address - Phone:404-215-6520
Mailing Address - Fax:404-688-8883
Practice Address - Street 1:550 PEACHTREE ST NE
Practice Address - Street 2:SUITE 1230
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2238
Practice Address - Country:US
Practice Address - Phone:404-215-6520
Practice Address - Fax:404-688-8883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty