ENT OF ATLANTA LLC (NPI# 1407017437) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407017437 |
| Entity Type | Organization |
| Organization Name | ENT OF ATLANTA LLC |
| Practice Address |
4380 Georgetown Sq Ste 1002 Atlanta GA 30338-6254 |
| Practice Telephone | 7702208400 |
| Practice Fax Number | 7702349979 |
| Mailing Telephone | 7702208400 |
| Mailing Fax Number | 7702349979 |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2008-06-23 |
| Authorized Official Name | JOSE PABLO STOLOVITZKY (PHYSICIAN/CEO) |
| Authorized Official Telephone | 7702208400 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | Allopathic & Osteopathic Physicians |
| Street Address |
4380 GEORGETOWN SQ STE 1002 |
| City | ATLANTA |
| State | GA |
| Zip Code | 30338-6254 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215108824 | Karl E. Doyle | Audiologist | 4380 Georgetown Sq, Ste 1002, Atlanta, GA 30338-6254 | 2008-03-23 |
| 1801224506 | Georgia Surgical Professional Services, LLC | Otolaryngology | 4380 Georgetown Sq, Suite 1002, Atlanta, GA 30338-6254 | 2013-10-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629606264 | Jasmine Donesha Shackelford | Student in an Organized Health Care Education/Training Program | Emory Family Medicine, 4500 North Shallowford Road, Atlanta, GA 30338 | 2020-03-30 |
| 1558907774 | Brianna Harding | Pharmacist | 4608 Devonshire Road, Dunwoody, GA 30338 | 2019-11-22 |
| 1194382135 | Kadan Corporation | In Home Supportive Care | 1848 Independence Square, Suite A, Dunwoody, GA 30338 | 2019-05-24 |
| 1144789553 | Carla Fabiola Nunez | Dentist | 5200 Roberts Dr, Atlanta, GA 30338 | 2019-03-15 |
| 1861978793 | Uhs of Peachford Lp | Pharmacy | 2150 Peachford Rd Ste D, Atlanta, GA 30338 | 2018-07-13 |
| 1275047474 | Mary Rose Ziemba | Physical Therapist | 4516 Chamblee Dunwoody Rd # 22, Dunwoody, GA 30338 | 2017-11-27 |
| 1992223531 | Joel Moorhead | Physical Medicine & Rehabilitation | 1521 Eidson Hall Drive, Dunwoody, GA 30338 | 2017-09-05 |
| 1336667997 | Absolute Holistic Medicine | Clinic/Center | 1868 Independence Sq, Suite A, Atlanta, GA 30338 | 2017-09-05 |
| 1164947115 | Modern Dermatology Atlanta | Dermatology | 5696 Whitehall Walk, Dunwoody, GA 30338 | 2017-08-11 |
| 1366972150 | A Caring Approach To Home Health Services Inc. | In Home Supportive Care | 200 Ashford Center North, Suite 370, Atlanta, GA 30338 | 2017-06-14 |
| Find all providers in zip 30338 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376928069 | Wiley A. Parker M.d PC | Otolaryngology | 5669 Peachtree Dunwoody Ste 295, Atlanta, GA 30342-1719 | 2015-07-23 |
| 1730576638 | Mark Arnold | Otolaryngology | 550 Peachtree St Ne Ste 1135550, Atlanta, GA 30308-2247 | 2015-04-20 |
| 1750709770 | Paul Pedram Daraei | Otolaryngology | 6085 Barfield Rd Ste 100, Atlanta, GA 30328-4403 | 2014-04-07 |
| 1588906739 | Zhong Zheng | Otolaryngology | 2061 Peachtree Rd Nw Suite 300, Atlanta, GA 30363 | 2013-03-25 |
| 1932447208 | David Max Cohen | Otolaryngology | 3431 W Paces Ferry Ct Nw, Atlanta, GA 30327-2228 | 2013-01-22 |
| 1669739793 | Lori Michele Guillot | Otolaryngology | 5461 Meridian Mark Rd Ste 130, Atlanta, GA 30342 | 2012-04-13 |
| 1801186192 | Lauren Luk | Otolaryngology | 550 Peachtree St Ne, Suite 1135, Emory University Hospital Midtown, Dept of Otolarngol., Atlanta, GA 30308 | 2011-04-08 |
| 1063567469 | Khuong V Nguyen | Otolaryngology | 4337 Buford Hwy, Ste 200, Atlanta, GA 30341-5044 | 2007-01-24 |
| 1730116161 | Daniel G Carothers | Otolaryngology | 2140 Peachtree Rd Nw Ste 360, Atlanta, GA 30309-1316 | 2006-06-28 |
| 1053348060 | Sarah K Wise | Otolaryngology | Emory Department of Otolaryngology, 1365a Clifton Road Ne, Suite A2300, Atlanta, GA 30322-0001 | 2006-06-26 |
| Find all providers in ATLANTA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.