1629147475 NPI number — MARGARET SINCLAIR TALMADGE PAC

Table of content: MARGARET SINCLAIR TALMADGE PAC (NPI 1629147475)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629147475 NPI number — MARGARET SINCLAIR TALMADGE PAC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TALMADGE
Provider First Name:
MARGARET
Provider Middle Name:
SINCLAIR
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PAC
Provider Gender Code:
F

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:
1629147475
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/21/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
993 JOHNSON FERRY RD STE D440
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:
30342-4780
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
404-217-7247
Provider Business Mailing Address Fax Number:
404-256-5475

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
993D JOHNSON FERRY ROAD
Provider Second Line Business Practice Location Address:
SUITE 440 THE CHILDRENS CENTER FOR DIGESTIVE HEALTH CAR
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:
404-257-0799
Provider Business Practice Location Address Fax Number:
404-503-2280
Provider Enumeration Date:
11/07/2006

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: 363A00000X , with the licence number:  004467 , 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)





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