KENNESTONE HEART PHYSICIANS GROUP NPI 1306086228

NPI Information

  • NPI: 1306086228
  • Provider Name: KENNESTONE HEART PHYSICIANS GROUP
  • Classification: Internal Medicine - 207RC0000X
  • Specialization: Cardiovascular Disease
  • Entity Type: Organization
  • Address: 200 OAKSIDE LN
    SUITE D
    CANTON, GA
    ZIP 30114
  • Phone: (770) 426-4721

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NPI Details

KENNESTONE HEART PHYSICIANS GROUP is a cardiovascular disease internal medicine in Canton, GA. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. KENNESTONE HEART PHYSICIANS GROUP NPI is 1306086228. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

200 OAKSIDE LN
SUITE D
CANTON, GA
ZIP 30114-416
Phone: (770) 426-4721
Fax: (678) 880-6513

The provider's authorized official is Wm Michael Brown .
The authorized official title is President and has the following contact phone number (678) 797-4113.

The enumeration date for this NPI number is 3/5/2009 and was last updated on 3/5/2009.

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
1207RC0000XInternal MedicineCardiovascular Disease2009PROFS-0051GEORGIAYes

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 Other Provider Identifier Issuer
1300025641KMEDICAIDGEORGIA

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: 3/30/2025

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