Provider Demographics
NPI:1114177631
Name:NORTH ATLANTA PSYCHIATRY
Entity Type:Organization
Organization Name:NORTH ATLANTA PSYCHIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:JYOTHI
Authorized Official - Middle Name:N
Authorized Official - Last Name:MATTAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-575-7294
Mailing Address - Street 1:7902 AMAWALK CIRCLE
Mailing Address - Street 2:
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30097
Mailing Address - Country:US
Mailing Address - Phone:678-575-7294
Mailing Address - Fax:770-225-3001
Practice Address - Street 1:3582 OLD MILTON PKWY
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-4465
Practice Address - Country:US
Practice Address - Phone:770-225-3000
Practice Address - Fax:770-225-3001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-19
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty