# BOARD OF REGENTS OF THE UNIVERSITY SYSTEM OF GEORGIA AND ON BEHALF....

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** BOARD OF REGENTS OF THE UNIVERSITY SYSTEM OF GEORGIA AND ON BEHALF....
- **Other names:** Student Health Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1245965813
- **Legal business name:** BOARD OF REGENTS OF THE UNIVERSITY SYSTEM OF GEORGIA AND ON BEHALF....
- **Authorized official:** DR. SUSAN MARIE WHITMER MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (404) 413-1930

## Contact information

- **Practice address:** 141 PIEDMONT AVE NE STE D, ATLANTA, GA 30303-2417
- **Practice address phone:** (404) 413-1930
- **Practice address fax:** (404) 413-1955
- **Mailing address:** PO BOX 3996, ATLANTA, GA 30302-3996
- **Mailing address phone:** (404) 413-1930
- **Mailing address fax:** (404) 413-1955

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/19/2022
- **Last updated:** 07/19/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1639373426 | NPI | — |