| NPI | 1457695488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOUETTA CODY Mgr, Provider Enrollment 404-785-7876 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology |
| 207ZP0213X Pathology, Pediatric Pathology | |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine | |
| 2085P0229X Radiology, Pediatric Radiology | |
| 363LN0000X Nurse Practitioner, Neonatal | |
| 363LP0200X Nurse Practitioner, Pediatrics | |
| 367H00000X Anesthesiologist Assistant | |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2023-02-23 |