Provider Demographics
NPI:1235995796
Name:ATLANTA FAMILY PRACTICE
Entity type:Organization
Organization Name:ATLANTA FAMILY PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRARA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-805-7425
Mailing Address - Street 1:2140 PEACHTREE RD NW STE 360A
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1314
Mailing Address - Country:US
Mailing Address - Phone:678-805-7425
Mailing Address - Fax:404-937-6299
Practice Address - Street 1:2140 PEACHTREE RD NW STE 360A
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1314
Practice Address - Country:US
Practice Address - Phone:678-805-7425
Practice Address - Fax:404-937-6299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-22
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty