Provider Demographics
NPI:1265502892
Name:NEPHROLOGY CONSULTANTS OF GEORGIA, P.C.
Entity Type:Organization
Organization Name:NEPHROLOGY CONSULTANTS OF GEORGIA, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:FRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MACONI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-352-3300
Mailing Address - Street 1:275 COLLIER RD NW
Mailing Address - Street 2:SUITE 290
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1709
Mailing Address - Country:US
Mailing Address - Phone:404-352-3300
Mailing Address - Fax:404-477-2276
Practice Address - Street 1:275 COLLIER RD NW
Practice Address - Street 2:SUITE 290
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1709
Practice Address - Country:US
Practice Address - Phone:404-352-3300
Practice Address - Fax:404-477-2276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP3737Medicare ID - Type UnspecifiedGROUP NUMBER