Provider Demographics
NPI:1972774412
Name:ALEXANDER MESKI MD PC
Entity Type:Organization
Organization Name:ALEXANDER MESKI MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:MESKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-214-2300
Mailing Address - Street 1:100 PROFESSIONAL PL
Mailing Address - Street 2:SUITE 301
Mailing Address - City:CARROLLTON
Mailing Address - State:GA
Mailing Address - Zip Code:30117-3874
Mailing Address - Country:US
Mailing Address - Phone:770-214-2300
Mailing Address - Fax:770-214-9756
Practice Address - Street 1:100 PROFESSIONAL PL
Practice Address - Street 2:SUITE 301
Practice Address - City:CARROLLTON
Practice Address - State:GA
Practice Address - Zip Code:30117-3874
Practice Address - Country:US
Practice Address - Phone:770-214-2300
Practice Address - Fax:770-214-9756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-12
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0488022084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP6657OtherMEDICARE GROUP