Provider Demographics
NPI:1609887710
Name:PARASITIC DISEASE CONSULTANTS
Entity Type:Organization
Organization Name:PARASITIC DISEASE CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LABORATORY DIRECTOR OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IRVING
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:KAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:770-496-1370
Mailing Address - Street 1:2177 FLINTSTONE DR STE J
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-5000
Mailing Address - Country:US
Mailing Address - Phone:770-496-1370
Mailing Address - Fax:770-938-7189
Practice Address - Street 1:2177 FLINTSTONE DR STE J
Practice Address - Street 2:
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-5000
Practice Address - Country:US
Practice Address - Phone:770-496-1370
Practice Address - Fax:770-938-7189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA044-041291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory