EMORY MEDICAL GROUP LLC NPI 1568661510

NPI Information

  • NPI: 1568661510
  • Provider Name: EMORY MEDICAL GROUP, LLC
  • Classification: Clinic/Center - 261QS0112X
  • Specialization: Oral and Maxillofacial Surgery
  • Entity Type: Organization
  • CLIA Number: 11D0259401
  • Address: 1365B CLIFTON RD NE
    ATLANTA, GA
    ZIP 30322
  • Phone: (404) 778-4500

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NPI Details

EMORY MEDICAL GROUP, LLC is an oral and maxillofacial surgery clinic center in Atlanta, GA. The provider is an oral and maxillofacial surgery clinic or center specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. EMORY MEDICAL GROUP, LLC NPI is 1568661510. The provider is registered as an organization entity type.

The provider's business location address is:

1365B CLIFTON RD NE
ATLANTA, GA
ZIP 30322-013
Phone: (404) 778-4500
Fax: (404) 778-5879

The provider's authorized official is Donald I Brunn .
The authorized official title is Coo and has the following contact phone number (404) 778-4871.

The CLIA number assigned to this NPI record is 11D0259401 - hospital with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 7/11/2007 and was last updated on 7/11/2007.

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
1261QS0112XClinic/CenterOral and Maxillofacial SurgeryYes

What is NPI?

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This page was last updated on: 11/21/2025

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