Provider Demographics
NPI:1437639309
Name:NORTH ATLANTA NEUROLOGICAL SERVICES, LLC
Entity Type:Organization
Organization Name:NORTH ATLANTA NEUROLOGICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:DOREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHINN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-900-9540
Mailing Address - Street 1:850 DOGWOOD RD STE B2002017
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-7218
Mailing Address - Country:US
Mailing Address - Phone:404-900-9540
Mailing Address - Fax:
Practice Address - Street 1:850 DOGWOOD RD # 2002017
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044-7218
Practice Address - Country:US
Practice Address - Phone:404-900-9540
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204R00000XAllopathic & Osteopathic PhysiciansElectrodiagnostic MedicineGroup - Multi-Specialty