Provider Demographics
NPI:1740558485
Name:ATLANTA HEADACHE SPECIALISTS
Entity Type:Organization
Organization Name:ATLANTA HEADACHE SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:BERENSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-278-9798
Mailing Address - Street 1:5887 GLENRIDGE DR NE
Mailing Address - Street 2:SUITE 140
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-5574
Mailing Address - Country:US
Mailing Address - Phone:678-278-9798
Mailing Address - Fax:800-652-2920
Practice Address - Street 1:5887 GLENRIDGE DR NE
Practice Address - Street 2:SUITE 140
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-5574
Practice Address - Country:US
Practice Address - Phone:678-278-9798
Practice Address - Fax:800-652-2920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-08
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty