Provider Demographics
NPI:1427151687
Name:EAR, NOSE AND THROAT SPECIALISTS, LLC
Entity type:Organization
Organization Name:EAR, NOSE AND THROAT SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANNELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-712-2297
Mailing Address - Street 1:1370 WELLBROOK CIR NE
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30012-3872
Mailing Address - Country:US
Mailing Address - Phone:770-922-5458
Mailing Address - Fax:770-922-0435
Practice Address - Street 1:1370 WELLBROOK CIR NE
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30012-3872
Practice Address - Country:US
Practice Address - Phone:770-922-5458
Practice Address - Fax:678-750-0988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP4065OtherMEDICARE
GACH9053OtherRAILROAD MEDICARE
GACH9053OtherRAILROAD MEDICARE