Id Group Of Atlanta

LBN: Id Group Of Atlanta
Id Group Of Atlanta is an health care organization with primary practice located at 735 Piedmont Avenue, Ne , Atlanta GA 30308. The organization recently has only one registered license in Suppliers / Non-Pharmacy Dispensing Site, which is considered as the primary health care specialty. Id Group Of Atlanta can be contacted via phone (404) 588-4680, or through Ouderkirk, John P via phone (404) 588-4680.

Contact Information

Primary practice address
735 Piedmont Avenue, Ne Atlanta GA 30308
Phone: (404) 588-4680
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Ouderkirk, John P Doctor of Medicine (MD)
Phone: (404) 588-4680

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Non-Pharmacy Dispensing Site 332900000X 049992 Georgia

Profile Details

NPI number 1063833267
LBN Legal business name Id Group Of Atlanta
DBA Doing business as
Authorized official Ouderkirk, John P Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Dec 16th, 2013
Last updated Dec 16th, 2013 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063833267 NPPES
Georgia MEDICAID 000926318A

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