Provider Demographics
NPI:1326002825
Name:AGNES H HAN
Entity Type:Organization
Organization Name:AGNES H HAN
Other - Org Name:GASTROENTEROLOGY OF NORTH GEORGIA LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AGNES
Authorized Official - Middle Name:
Authorized Official - Last Name:HAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-252-7703
Mailing Address - Street 1:960 JOHNSON FERRY RD
Mailing Address - Street 2:SUITE 515
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1611
Mailing Address - Country:US
Mailing Address - Phone:404-252-7703
Mailing Address - Fax:404-252-8863
Practice Address - Street 1:960 JOHNSON FERRY RD
Practice Address - Street 2:SUITE 515
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1611
Practice Address - Country:US
Practice Address - Phone:404-252-7703
Practice Address - Fax:404-252-8863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-13
Last Update Date:2010-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty