1245218445 NPI number — JOHN RICHARD STEELE M.D.

Table of content: JOHN RICHARD STEELE M.D. (NPI 1245218445)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245218445 NPI number — JOHN RICHARD STEELE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STEELE
Provider First Name:
JOHN
Provider Middle Name:
RICHARD
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
STEELE
Provider Other First Name:
J.
Provider Other Middle Name:
RICHARD
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1245218445
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1100 JOHNSON FERRY RD NE
Provider Second Line Business Mailing Address:
SUITE 245
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30342-1709
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
404-250-6797
Provider Business Mailing Address Fax Number:
404-256-3271

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5665 PEACHTREE DUNWOODY RD NE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30342-1764
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-257-2450
Provider Business Practice Location Address Fax Number:
404-256-3271
Provider Enumeration Date:
01/06/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X , with the licence number:  013828 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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