Provider Demographics
NPI:1467634915
Name:NEIL KAHN M.D.
Entity Type:Organization
Organization Name:NEIL KAHN M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:KAHN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-501-0001
Mailing Address - Street 1:2711 IRVIN WAY
Mailing Address - Street 2:SUITE 211
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-5405
Mailing Address - Country:US
Mailing Address - Phone:404-501-0001
Mailing Address - Fax:
Practice Address - Street 1:2711 IRVIN WAY
Practice Address - Street 2:SUITE 211
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-5405
Practice Address - Country:US
Practice Address - Phone:404-501-0001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEIL KAHN M.D.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-11-27
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA304892084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP3412Medicare PIN
GAD45805Medicare UPIN