Provider Demographics
NPI:1437113180
Name:MOHNEY, MARK W (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:W
Last Name:MOHNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3225 CUMBERLAND BLVD SE
Mailing Address - Street 2:SUITE 900
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-6407
Mailing Address - Country:US
Mailing Address - Phone:404-351-2220
Mailing Address - Fax:404-355-5624
Practice Address - Street 1:3225 CUMBERLAND BLVD SE STE 800
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-5970
Practice Address - Country:US
Practice Address - Phone:404-351-2220
Practice Address - Fax:404-355-5624
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA031800207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000393093AMedicaid
GAA02702Medicare UPIN
GA00965Medicare PIN
GA18BDBBXMedicare ID - Type Unspecified
GAC30849Medicare PIN