Provider Demographics
NPI:1669591756
Name:AWS PHYSICIANS, PC
Entity type:Organization
Organization Name:AWS PHYSICIANS, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:YVETTE
Authorized Official - Middle Name:M
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-252-5196
Mailing Address - Street 1:5445 MERIDIAN MARKS RD NE
Mailing Address - Street 2:SUITE 350
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-4763
Mailing Address - Country:US
Mailing Address - Phone:404-252-5196
Mailing Address - Fax:404-252-2414
Practice Address - Street 1:5445 MERIDIAN MARKS RD NE
Practice Address - Street 2:SUITE 350
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-4763
Practice Address - Country:US
Practice Address - Phone:404-252-5196
Practice Address - Fax:404-252-2414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA035294207V00000X
GA042776207V00000X
GA042010207V00000X
GA050217207V00000X
GA051032207V00000X
GA057039207V00000X
GA061194207V00000X
GA061197207V00000X
207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000540295BMedicaid
GA000915879AMedicaid
GA000979261CMedicaid
GA000733323CMedicaid
GA000540295BMedicaid
GA16BDSTVMedicare ID - Type UnspecifiedYVETTE M SMITH MD
GAE46989Medicare UPIN
GAG96436Medicare UPIN
GA16BBCHPMedicare ID - Type UnspecifiedMARIA E ARIAS MD
GAF81563Medicare UPIN
GA16BDVDPMedicare ID - Type UnspecifiedVALERIE LEAH MCKINNEY MD
GA16BBCHPMedicare ID - Type UnspecifiedMICHAEL A DAWSON MD
GAH00706Medicare UPIN
GA000915879AMedicaid