Provider Demographics
NPI:1487738225
Name:SLEEP QUEST DIAGNOSTICS, INC
Entity type:Organization
Organization Name:SLEEP QUEST DIAGNOSTICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:JERE
Authorized Official - Last Name:DOZIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-819-5463
Mailing Address - Street 1:4761 SPRINGDALE RD
Mailing Address - Street 2:
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30106-2033
Mailing Address - Country:US
Mailing Address - Phone:770-819-5463
Mailing Address - Fax:678-391-6907
Practice Address - Street 1:4761 SPRINGDALE RD
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-2033
Practice Address - Country:US
Practice Address - Phone:770-819-5463
Practice Address - Fax:678-391-6907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA=========OtherTAX ID