Provider Demographics
NPI:1225366826
Name:EMORY UNIVERSITY
Entity Type:Organization
Organization Name:EMORY UNIVERSITY
Other - Org Name:WINSHIP CANCER INSTITUTE
Other - Org Type:Other Name
Authorized Official - Title/Position:PROFESSOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JACQUES
Authorized Official - Middle Name:
Authorized Official - Last Name:GLAIPEAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-778-1779
Mailing Address - Street 1:1365 CLIFTON RD NE
Mailing Address - Street 2:B4302A
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322-1013
Mailing Address - Country:US
Mailing Address - Phone:404-778-1779
Mailing Address - Fax:404-778-4377
Practice Address - Street 1:1365 CLIFTON RD NE
Practice Address - Street 2:B4302A
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-1013
Practice Address - Country:US
Practice Address - Phone:404-778-1779
Practice Address - Fax:404-778-4377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-20
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA207RH0000X291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory