Provider Demographics
NPI:1720631047
Name:GREATER ATLANTA HEARING P C
Entity Type:Organization
Organization Name:GREATER ATLANTA HEARING P C
Other - Org Name:GREATER ATLANTA HEARING
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:KENNETH
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:678-771-8857
Mailing Address - Street 1:564 PEACHTREE PKWY STE 106
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-7401
Mailing Address - Country:US
Mailing Address - Phone:678-771-8857
Mailing Address - Fax:678-771-8862
Practice Address - Street 1:564 PEACHTREE PKWY STE 106
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-7401
Practice Address - Country:US
Practice Address - Phone:678-771-8857
Practice Address - Fax:678-771-8862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-17
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No332S00000XSuppliersHearing Aid EquipmentGroup - Single Specialty