LATHAN WYATT OVERSTREET M.D. NPI 1568521052

NPI Information

NPI: 1568521052
Provider Name: LATHAN WYATT OVERSTREET, M.D.
Classification: Specialist - 174400000X
Entity Type: Individual

PECOS Registration: Yes

Address:
3355 CASCADE RD SW
ATLANTA, GA
ZIP 30311
Phone: (404) 699-7096
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Lathan Wyatt Overstreet, M.D. is a specialist in Atlanta, GA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. Lathan Wyatt Overstreet, M.D. NPI is 1568521052. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3355 CASCADE RD SW
ATLANTA, GA
ZIP 30311-618
Phone: (404) 699-7096
Fax: (404) 699-9933

The NPI 1568521052 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 12/8/2006 and was last updated on 6/13/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	174400000X	Specialist		036659	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	16BDFQT	MEDICARE ID-TYPE UNSPECIFIED	GEORGIA
2	00646665C	MEDICAID	GEORGIA
3	F97830	MEDICARE UPIN	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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