Midtown West Medical, Pc

LBN: Midtown West Medical, Pc
Midtown West Medical, Pc is an health care organization with primary practice located at 957 W Marietta St Nw , Atlanta GA 30318-5282. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as the primary health care specialty. Midtown West Medical, Pc can be contacted via phone (404) 817-0062, or through Johnson, Kimball A via phone (404) 817-0062.

Contact Information

Primary practice address
957 W Marietta St Nw Atlanta GA 30318-5282
Phone: (404) 817-0062
Fax: (404) 817-0064
Website:
Map and Directions
Authorized official contact:
Name: Johnson, Kimball A Doctor of Medicine (MD)
Phone: (404) 817-0062

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X GA32213 Georgia

Profile Details

NPI number 1689736654
LBN Legal business name Midtown West Medical, Pc
DBA Doing business as
Authorized official Johnson, Kimball A Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Dec 15th, 2006
Last updated Aug 29th, 2012 - about 13 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 1689736654 NPPES
Georgia Other 11D1012816 CLIA #
Georgia Other 495960 CLIA #

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