Provider Demographics
NPI:1497958409
Name:NORTHEAST ATLANTA ASSOCIATES IN GASTROENTEROLOGY
Entity Type:Organization
Organization Name:NORTHEAST ATLANTA ASSOCIATES IN GASTROENTEROLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:BETON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-939-4721
Mailing Address - Street 1:1459 MONTREAL RD
Mailing Address - Street 2:SU 204
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-6926
Mailing Address - Country:US
Mailing Address - Phone:770-939-4721
Mailing Address - Fax:770-939-1187
Practice Address - Street 1:1459 MONTREAL RD
Practice Address - Street 2:SU 204
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-6900
Practice Address - Country:US
Practice Address - Phone:770-939-4721
Practice Address - Fax:770-939-1187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty