Provider Demographics
NPI:1275978439
Name:ATLANTA CARDIOLOGY ASSOCIATES, LLC
Entity Type:Organization
Organization Name:ATLANTA CARDIOLOGY ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:WINSTON
Authorized Official - Middle Name:HAROLD
Authorized Official - Last Name:GANDY
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:404-272-4888
Mailing Address - Street 1:385 LUM CROWE RD
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-6879
Mailing Address - Country:US
Mailing Address - Phone:404-272-4888
Mailing Address - Fax:404-796-7099
Practice Address - Street 1:11680 GREAT OAKS WAY STE 100
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-2458
Practice Address - Country:US
Practice Address - Phone:404-272-4888
Practice Address - Fax:404-796-7099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-01
Last Update Date:2024-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA30065207RC0000X
261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Single Specialty