Provider Demographics
NPI:1932257433
Name:THE ATLANTA CARDIOLOGY GROUP, PC
Entity Type:Organization
Organization Name:THE ATLANTA CARDIOLOGY GROUP, PC
Other - Org Name:ACG BLUE RIDGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-242-1999
Mailing Address - Street 1:2855 OLD HIGHWAY 5
Mailing Address - Street 2:SUITE 106
Mailing Address - City:BLUE RIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30513-6248
Mailing Address - Country:US
Mailing Address - Phone:706-636-6500
Mailing Address - Fax:706-636-6501
Practice Address - Street 1:2855 OLD HIGHWAY 5
Practice Address - Street 2:SUITE 106
Practice Address - City:BLUE RIDGE
Practice Address - State:GA
Practice Address - Zip Code:30513-6248
Practice Address - Country:US
Practice Address - Phone:706-636-6500
Practice Address - Fax:706-636-6501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty