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KENNESTONE HEART PHYSICIANS GROUP NPI 1962566042


NPI Information

NPI: 1962566042
Provider Name: KENNESTONE HEART PHYSICIANS GROUP
Classification: Internal Medicine - 207RC0000X
Entity Type: Organization

Specialization: Cardiovascular Disease

Address:
120 STONEBRIDGE PKWY
SUITE 440
WOODSTOCK, GA
ZIP 30189
Phone: (770) 426-4721
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KENNESTONE HEART PHYSICIANS GROUP is a cardiovascular disease internal medicine in Woodstock, GA. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. KENNESTONE HEART PHYSICIANS GROUP NPI is 1962566042. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

120 STONEBRIDGE PKWY
SUITE 440
WOODSTOCK, GA
ZIP 30189-767
Phone: (770) 426-4721

The provider's authorized official is Katie M Doyle .
The authorized official title is Manager, Physician Services and has the following contact phone number (678) 797-4113.

The enumeration date for this NPI number is 12/21/2006 and was last updated on 4/10/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RC0000XInternal MedicineCardiovascular Disease21937GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1GRP938MEDICARE PINGEORGIA
2300025641KMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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