1750437406 NPI number — NORTH ATLANTA HEAD AND NECK SURGERY CENTER

Table of content: MRS. STEPHANIE ANN DEVITT PT, DPT, CLT (NPI 1861754731)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750437406 NPI number — NORTH ATLANTA HEAD AND NECK SURGERY CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTH ATLANTA HEAD AND NECK SURGERY CENTER
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:
1750437406
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:
980 JOHNSON FERRY RD NE
Provider Second Line Business Mailing Address:
SUITE 110
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30342-1626
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
404-843-9143
Provider Business Mailing Address Fax Number:
404-250-1881

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
980 JOHNSON FERRY RD NE
Provider Second Line Business Practice Location Address:
SUITE 110
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30342-1626
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-843-9143
Provider Business Practice Location Address Fax Number:
404-250-1881
Provider Enumeration Date:
01/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SINHA
Authorized Official First Name:
PRADEEP
Authorized Official Middle Name:
K
Authorized Official Title or Position:
OWNER PHYSICIAN
Authorized Official Telephone Number:
404-843-9143

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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