Basic Information
| Provider Information | |||||||||
| NPI: | 1225301294 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RESPIRATORY CONSULTANTS OF GEORGIA SLEEP CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 21 POINTE NORTH DR | ||||||||
| Address2: | |||||||||
| City: | CARTERSVILLE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 301207952 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6787210705 | ||||||||
| FaxNumber: | 6787215116 | ||||||||
| Practice Location | |||||||||
| Address1: | 21 POINTE NORTH DR | ||||||||
| Address2: | |||||||||
| City: | CARTERSVILLE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 301207952 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6787210705 | ||||||||
| FaxNumber: | 6787215116 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/21/2012 | ||||||||
| LastUpdateDate: | 02/21/2012 | ||||||||
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| AuthorizedOfficialLastName: | RHODES | ||||||||
| AuthorizedOfficialFirstName: | MELISS | ||||||||
| AuthorizedOfficialMiddleName: | BRUCE | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6787210705 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RS0012X | 047060 | GA | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Sleep Medicine |
No ID Information.