1922218692 NPI number — DNK HEALTHCARE

Table of content: (NPI 1922218692)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922218692 NPI number — DNK HEALTHCARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DNK HEALTHCARE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CONTACTS BY DESIGN
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1922218692
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/08/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
25 EQUESTRIAN WAY NE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CARTERSVILLE
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30121-8032
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
404-323-2020
Provider Business Mailing Address Fax Number:
404-412-2020

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1995 N PARK PL SE
Provider Second Line Business Practice Location Address:
SUITE 310P
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30339-7801
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-323-2020
Provider Business Practice Location Address Fax Number:
404-412-2020
Provider Enumeration Date:
05/23/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MYER
Authorized Official First Name:
DAN
Authorized Official Middle Name:
L
Authorized Official Title or Position:
PRACTITIONER
Authorized Official Telephone Number:
404-323-2020

Provider Taxonomy Codes

  • Taxonomy code: 156FC0801X , with the licence number:  LDO1683 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 156FX1800X , with the licence number: LDO1683 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332H00000X , with the licence number: GA1683 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 335E00000X , with the licence number: GA1683 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)