1982221693 NPI number — NORTH FULTON MEDICAL CONSULTANTS

Table of content: DR. DOROTHY WATERBURY BIRD M.D. (NPI 1225361967)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982221693 NPI number — NORTH FULTON MEDICAL CONSULTANTS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTH FULTON MEDICAL CONSULTANTS
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:
1982221693
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/29/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3162 JOHNSON FERRY RD STE 260-425
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MARIETTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30062-7604
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
404-384-5637
Provider Business Mailing Address Fax Number:
770-640-9013

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3162 JOHNSON FERRY RD STE 260-425
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MARIETTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30062-7604
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-384-5637
Provider Business Practice Location Address Fax Number:
770-640-9013
Provider Enumeration Date:
06/29/2020

Additional Information

Authorized Official

Authorized Official Last Name:
ROBINSON-WAITS
Authorized Official First Name:
KATHY
Authorized Official Middle Name:
D
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
404-384-5637

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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