Provider Demographics
NPI:1811386022
Name:DUNWOODY PERSONAL HEALTH CARE PC
Entity Type:Organization
Organization Name:DUNWOODY PERSONAL HEALTH CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:KINAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-481-0987
Mailing Address - Street 1:5471 CHAMBLEE DUNWOODY RD
Mailing Address - Street 2:
Mailing Address - City:DUNWOODY
Mailing Address - State:GA
Mailing Address - Zip Code:30338-4114
Mailing Address - Country:US
Mailing Address - Phone:770-481-0987
Mailing Address - Fax:770-481-0986
Practice Address - Street 1:5471 CHAMBLEE DUNWOODY RD
Practice Address - Street 2:
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-4114
Practice Address - Country:US
Practice Address - Phone:770-481-0987
Practice Address - Fax:770-481-0986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-12
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA35277207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty