Basic Information
Provider Information
NPI: 1750672408
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ENGLAND
FirstName: JOHN
MiddleName: A
NamePrefix:  
NameSuffix:  
Credential: MS RRT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
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Mailing Information
Address1: 3495 PIEDMONT ROAD, NE
Address2: NINE PIEDMONT CENTER
City: ATLANTA
State: GA
PostalCode: 30305
CountryCode: US
TelephoneNumber: 4043647070
FaxNumber:  
Practice Location
Address1: 2004 PEACHTREE ROAD NW SUITE 100
Address2: KAISER PERMANENTE PIEDMONT SPECIALTY
City: ATLANTA
State: GA
PostalCode: 30309
CountryCode: US
TelephoneNumber: 4045042650
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/29/2011
LastUpdateDate: 04/29/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
227800000X980GAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified 

No ID Information.


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