Provider Demographics
NPI:1821844622
Name:PEDIATRIC AUDIOLOGY OF ATLANTA
Entity type:Organization
Organization Name:PEDIATRIC AUDIOLOGY OF ATLANTA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:JANELLE
Authorized Official - Last Name:HARMON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-886-0505
Mailing Address - Street 1:5461 MERIDIAN MARK RD STE 140
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-3007
Mailing Address - Country:US
Mailing Address - Phone:404-591-1884
Mailing Address - Fax:
Practice Address - Street 1:5461 MERIDIAN MARK RD STE 140
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-3007
Practice Address - Country:US
Practice Address - Phone:404-591-1884
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty