1144125550 NPI number — ALLERGY ASTHMA & IMMUNOLOGY SPECIALISTS OF GEORGIA, LLC

Table of content: (NPI 1144125550)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144125550 NPI number — ALLERGY ASTHMA & IMMUNOLOGY SPECIALISTS OF GEORGIA, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALLERGY ASTHMA & IMMUNOLOGY SPECIALISTS OF GEORGIA, LLC
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:
Provider Other Organization Name Type Code:
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:
1144125550
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/14/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1925 E GLENN AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AUBURN
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36830-5729
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
706-803-0789
Provider Business Mailing Address Fax Number:
706-803-0799

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2000 HAMILTON RD STE A2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31904-8907
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-803-0789
Provider Business Practice Location Address Fax Number:
706-803-0799
Provider Enumeration Date:
10/14/2026

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
TOLE
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
W
Authorized Official Title or Position:
OWNER / PHYSICIAN
Authorized Official Telephone Number:
334-528-0059

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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