Provider Demographics
NPI:1114256427
Name:EMORY CHILDREN'S CENTER
Entity Type:Organization
Organization Name:EMORY CHILDREN'S CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE PROFESSOR OF PEDIATRICS
Authorized Official - Prefix:DR
Authorized Official - First Name:ANN
Authorized Official - Middle Name:D
Authorized Official - Last Name:CRITZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-686-8136
Mailing Address - Street 1:550 PEACHTREE ST NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-2208
Mailing Address - Country:US
Mailing Address - Phone:404-727-2966
Mailing Address - Fax:404-727-3236
Practice Address - Street 1:2015 UPPERGATE DR
Practice Address - Street 2:SUITE 208
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-0001
Practice Address - Country:US
Practice Address - Phone:404-727-2966
Practice Address - Fax:404-727-3236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-15
Last Update Date:2009-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAR61462282NC0060X
GARN61462363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical CareGroup - Single Specialty
No282NC0060XHospitalsGeneral Acute Care HospitalCritical Access