Provider Demographics
NPI:1811206295
Name:JOHNS CREEK NEONATOLOGY
Entity Type:Organization
Organization Name:JOHNS CREEK NEONATOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRINCIPLE
Authorized Official - Prefix:DR
Authorized Official - First Name:ATHI
Authorized Official - Middle Name:
Authorized Official - Last Name:NARAYAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-474-7507
Mailing Address - Street 1:100 CLUB CT
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-8779
Mailing Address - Country:US
Mailing Address - Phone:770-889-8417
Mailing Address - Fax:
Practice Address - Street 1:6325 HOSPITAL PKWY
Practice Address - Street 2:
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30097-5775
Practice Address - Country:US
Practice Address - Phone:678-474-7507
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-01
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA48376208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty