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Organization
ASTHMA ALLERGY AND IMMUNOLOGY CLINIC LLC
Active
Organization
ASTHMA ALLERGY AND IMMUNOLOGY CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HOSAMANE S PRABHAKARA MD (PRESIDENT)
(678) 489-7901
Entity
Organization
Contact information
Practice address
147 N PARK TRL, STOCKBRIDGE, GA 30281-7373
(678) 489-7901
(833) 559-0864
Mailing address
756 PENINSULA OVERLOOK, HAMPTON, GA 30228-6062
(678) 489-7901
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
—
—
207KA0200X
Allergy Physician
—
—
Other
Enumeration date
12/10/2021
Last updated
04/04/2022
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