Provider Demographics
NPI:1699164657
Name:GEORGIA PHYSICIANS OF CARDIOLOGY, LLC
Entity type:Organization
Organization Name:GEORGIA PHYSICIANS OF CARDIOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL CFO, TENET
Authorized Official - Prefix:MR
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:O
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-265-5009
Mailing Address - Street 1:PO BOX 743266
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3266
Mailing Address - Country:US
Mailing Address - Phone:404-874-1788
Mailing Address - Fax:404-872-4589
Practice Address - Street 1:999 PEACH STREET NE,
Practice Address - Street 2:STE 850
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-3964
Practice Address - Country:US
Practice Address - Phone:404-874-1788
Practice Address - Fax:404-872-4589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-14
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear CardiologyGroup - Multi-Specialty