Provider Demographics
NPI:1285043158
Name:GREATER ATLANTA ANESTHESIA, LLC
Entity Type:Organization
Organization Name:GREATER ATLANTA ANESTHESIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GAYE
Authorized Official - Middle Name:SMITH
Authorized Official - Last Name:PENNINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:MHA
Authorized Official - Phone:404-355-3200
Mailing Address - Street 1:95 COLLIER RD NW
Mailing Address - Street 2:SUITE 4075
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1796
Mailing Address - Country:US
Mailing Address - Phone:404-355-3200
Mailing Address - Fax:404-350-9316
Practice Address - Street 1:95 COLLIER RD NW
Practice Address - Street 2:SUITE 4075
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1796
Practice Address - Country:US
Practice Address - Phone:404-355-3200
Practice Address - Fax:404-350-9316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-05
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty