Provider Demographics
NPI:1922417633
Name:GEORGIA NEURODIAGNOSTIC & TREATMENT CENTER LLC.
Entity Type:Organization
Organization Name:GEORGIA NEURODIAGNOSTIC & TREATMENT CENTER LLC.
Other - Org Name:NEUROLOGY SPECIALISTS OF GA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:DR
Authorized Official - First Name:DONG
Authorized Official - Middle Name:M
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:HONG YANG
Authorized Official - Phone:678-878-2989
Mailing Address - Street 1:3859 POSTAL DR STE 100
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-3211
Mailing Address - Country:US
Mailing Address - Phone:678-878-2989
Mailing Address - Fax:678-878-2990
Practice Address - Street 1:3859 POSTAL DR STE 100
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-3211
Practice Address - Country:US
Practice Address - Phone:678-878-2989
Practice Address - Fax:678-878-2990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-06
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty