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Specialty details in registry · Atlanta, GA

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At a glance

91 W Wieuca Rd Ne Ste 300, Atlanta, GA 30342-3248

NPPES record updated Jan 31, 2024. Public records can lag behind changes at a practice.

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Insurance participation and appointment availability are not established by these public records.

Practice location

91 W Wieuca Rd Ne Ste 300
Atlanta, GA 30342-3248

Professional details: NPI, taxonomy & registry record

NPI1861255093

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Registry details

Primary taxonomy: Specialty details in registry
Taxonomy code: 1223X0400X
Enumeration date: Jan 31, 2024
Record updated: Jan 31, 2024

More registry details

Provider type: Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

1223X0400X · Primary

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

91 W Wieuca Rd Ne Ste 300
Atlanta, GA 30342-3248

Phone: (404) 303-7400

Mailing address

1610 54TH AVE N STE 205

NASHVILLE, TN 372091442

Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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