| NPI | 1184779332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOUETTA CODY Manager, Provider Enrollment 404-785-7876 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics Pediatric Hematology-Oncology |
| Additional Taxonomies | 207ZP0213X Pathology Pediatric Pathology |
| 2080P0204X Pediatrics Pediatric Emergency Medicine | |
| 2081P0010X Physical Medicine & Rehabilitation Pediatric Rehabilitation Medicine | |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry | |
| 208M00000X Hospitalist | |
| 363LP0200X Nurse Practitioner Pediatrics | |
| 103G00000X Clinical Neuropsychologist | |
| 122300000X Dentist | |
| 1223P0221X Dentist Pediatric Dentistry | |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2025-01-10 |