1366423915 NPI number — NORTH ATLANTA RADIATION ONCOLOGY

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366423915 NPI number — NORTH ATLANTA RADIATION ONCOLOGY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTH ATLANTA RADIATION ONCOLOGY
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:
1366423915
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 409531
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30384-9531
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
770-693-6022
Provider Business Mailing Address Fax Number:
770-693-6039

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
SAINT JOSEPH'S HOSPITAL
Provider Second Line Business Practice Location Address:
5665 PEACHTREE DUNWOODY ROAD
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30342
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-851-7004
Provider Business Practice Location Address Fax Number:
404-851-7015
Provider Enumeration Date:
11/10/2005

Additional Information

Authorized Official

Authorized Official Last Name:
CLINE
Authorized Official First Name:
HENRY
Authorized Official Middle Name:
D
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
404-851-7004

Provider Taxonomy Codes

  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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