Provider Demographics
NPI:1124411988
Name:PIEDMONT INTERNAL MEDICINE, P.C.
Entity Type:Organization
Organization Name:PIEDMONT INTERNAL MEDICINE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WELBORN
Authorized Official - Middle Name:CODY
Authorized Official - Last Name:MCCLATCHEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-351-7467
Mailing Address - Street 1:3280 HOWELL MILL RD NW STE 150
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327-4102
Mailing Address - Country:US
Mailing Address - Phone:404-351-7467
Mailing Address - Fax:404-352-1175
Practice Address - Street 1:3280 HOWELL MILL RD NW STE 150
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-4102
Practice Address - Country:US
Practice Address - Phone:404-351-7467
Practice Address - Fax:404-352-1175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-17
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty