# NORTHEAST GEORGIA DIAGNOSTIC ASSOCIATES AND CLINIC, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144719311
- **Authorized official:** AMY E FOUTS (CHIEF COMPLIANCE OFFICER)
- **Authorized official phone:** (404) 851-6968

## Contact information

- **Practice address:** 1240 JESSE JEWELL PKWY SE STE 500, GAINESVILLE, GA 30501-3861
- **Practice address phone:** (855) 709-4535
- **Mailing address:** 1100 JOHNSON FY RD NE STE 780, ATLANTA, GA 30342-1743

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/03/2018
- **Last updated:** 09/03/2026