Basic Information
| Provider Information | |||||||||
| NPI: | 1841438520 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STINSON | ||||||||
| FirstName: | NATASHA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2727 PACES FERRY RD SE STE 1-1100 | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303396151 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4702713418 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2101 NEWNAN CROSSING BLVD E | ||||||||
| Address2: | |||||||||
| City: | NEWNAN | ||||||||
| State: | GA | ||||||||
| PostalCode: | 302652406 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6785526200 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/03/2009 | ||||||||
| LastUpdateDate: | 10/26/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/26/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 057193 | GA | N | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | 057193 | GA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 201350790 | 05 | IN | MEDICAID | 7100382070 | 05 | KY | MEDICAID |