Provider Demographics
NPI:1376642751
Name:EMORY HEALTH CARE
Entity Type:Organization
Organization Name:EMORY HEALTH CARE
Other - Org Name:EMORY CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:ASSOCIATE PROFESSOR NEUROLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:JUNCOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-728-4952
Mailing Address - Street 1:1841 CLIFTON RD.
Mailing Address - Street 2:WWHC NEUROLOGY
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-4021
Mailing Address - Country:US
Mailing Address - Phone:404-728-4952
Mailing Address - Fax:404-728-4892
Practice Address - Street 1:1841 CLIFTON RD.
Practice Address - Street 2:WWHC NEUROLOGY
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329-4021
Practice Address - Country:US
Practice Address - Phone:404-728-4952
Practice Address - Fax:404-728-4892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA301132084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAB61185Medicare UPIN