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SOUTH ATLANTA INTEGRATIVE MEDICINE NPI 1760848980


NPI Information

NPI: 1760848980
Provider Name: SOUTH ATLANTA INTEGRATIVE MEDICINE
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 11D2112333

Address:
1240 HIGHWAY 54 W
BUILDING 700, SUITE 700
FAYETTEVILLE, GA
ZIP 30214
Phone: (404) 452-9931
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SOUTH ATLANTA INTEGRATIVE MEDICINE is a family medicine in Fayetteville, GA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. SOUTH ATLANTA INTEGRATIVE MEDICINE NPI is 1760848980. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1240 HIGHWAY 54 W
BUILDING 700, SUITE 700
FAYETTEVILLE, GA
ZIP 30214-557
Phone: (404) 452-9931

The provider's authorized official is Lynn Stanley .
The authorized official title is Authorized Official and has the following contact phone number (404) 452-9931.

The CLIA number assigned to this NPI record is 11D2112333 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/4/2016 and was last updated on 1/4/2016.


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
1207Q00000XFamily MedicineYes

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: 5/5/2024

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