Provider Demographics
NPI:1619317542
Name:TRANSITIONAL CARE PHYSICIANS OF GEORGIA PC
Entity Type:Organization
Organization Name:TRANSITIONAL CARE PHYSICIANS OF GEORGIA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AMAR
Authorized Official - Middle Name:V
Authorized Official - Last Name:MOHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:888-772-0076
Mailing Address - Street 1:PO BOX 5856
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31107-0856
Mailing Address - Country:US
Mailing Address - Phone:888-772-0076
Mailing Address - Fax:770-751-8014
Practice Address - Street 1:704 BREEDLOVE DR
Practice Address - Street 2:STE A
Practice Address - City:MONROE
Practice Address - State:GA
Practice Address - Zip Code:30655-2054
Practice Address - Country:US
Practice Address - Phone:888-772-0076
Practice Address - Fax:770-751-8014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-25
Last Update Date:2014-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA66531174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty