Provider Demographics
NPI:1639339047
Name:ATLANTA SLEEP MEDICINE CLINIC, LLC
Entity Type:Organization
Organization Name:ATLANTA SLEEP MEDICINE CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:JONES
Authorized Official - Last Name:BEALS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-851-9998
Mailing Address - Street 1:1100 JOHNSON FERRY RD NE
Mailing Address - Street 2:SUITE 420
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1709
Mailing Address - Country:US
Mailing Address - Phone:404-851-9998
Mailing Address - Fax:404-851-9860
Practice Address - Street 1:1100 JOHNSON FERRY RD NE
Practice Address - Street 2:SUITE 420
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1709
Practice Address - Country:US
Practice Address - Phone:404-851-9998
Practice Address - Fax:404-851-9860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-10
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic