Provider Demographics
NPI:1871264606
Name:ASCENSION MEDICINES LLC
Entity Type:Organization
Organization Name:ASCENSION MEDICINES LLC
Other - Org Name:ASCENSION MEDICINES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:HUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-231-7689
Mailing Address - Street 1:3900 CROWN ROAD
Mailing Address - Street 2:#162696
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30321
Mailing Address - Country:US
Mailing Address - Phone:470-794-1288
Mailing Address - Fax:
Practice Address - Street 1:998 WINBURN DR
Practice Address - Street 2:
Practice Address - City:EAST POINT
Practice Address - State:GA
Practice Address - Zip Code:30344-2872
Practice Address - Country:US
Practice Address - Phone:706-231-7689
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-22
Last Update Date:2021-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty