Provider Demographics
NPI:1467445262
Name:NORTH FULTON ANESTHESIA ASSOCIATES PC
Entity Type:Organization
Organization Name:NORTH FULTON ANESTHESIA ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:DOWLING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:470-308-4905
Mailing Address - Street 1:PO BOX 106086
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30348-6086
Mailing Address - Country:US
Mailing Address - Phone:470-308-4905
Mailing Address - Fax:
Practice Address - Street 1:6105 PEACHTREE DUNWOODY RD STE B110
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-5911
Practice Address - Country:US
Practice Address - Phone:770-551-9944
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-26
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA207L00000X, 207LP2900X, 363L00000X, 367500000X, 367H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
No367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA=========OtherBLUE CROSS BLUE SHIELD
GA=========Medicaid
GA=========Medicaid