Provider Demographics
NPI:1518919356
Name:ATLANTA CARDIOLOGY CONSULTANTS, PC
Entity Type:Organization
Organization Name:ATLANTA CARDIOLOGY CONSULTANTS, PC
Other - Org Name:CARDIOLOGY CONSULTANTS OF NORTH FULTON, P.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:S
Authorized Official - Last Name:BACKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-751-9131
Mailing Address - Street 1:3905 BROOKSIDE PKWY STE 202
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-4425
Mailing Address - Country:US
Mailing Address - Phone:770-751-9131
Mailing Address - Fax:770-751-9132
Practice Address - Street 1:3905 BROOKSIDE PKWY STE 202
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-4425
Practice Address - Country:US
Practice Address - Phone:770-751-9131
Practice Address - Fax:770-751-9132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA030711207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GATAX ID NUMBEROtherUNITED HEALTHCARE
GATAX ID NUMBEROtherCIGNA
GA110033309OtherRAILROAD MEDICARE
GA484268OtherBCBS
GA0513347OtherAETNA
GA110033309OtherRAILROAD MEDICARE