# EAR, NOSE AND THROAT SPECIALISTS, LLC

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

## Provider details

- **NPI number:** 1427151687
- **Authorized official:** ANNELLE HUFFMAN (PRACTICE MANAGER)
- **Authorized official phone:** (770) 712-2297

## Contact information

- **Practice address:** 1370 WELLBROOK CIR NE, CONYERS, GA 30012-3872
- **Practice address phone:** (770) 922-5458
- **Practice address fax:** (678) 750-0988
- **Mailing address:** 1370 WELLBROOK CIR NE, CONYERS, GA 30012-3872
- **Mailing address phone:** (770) 922-5458
- **Mailing address fax:** (770) 922-0435

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/06/2006
- **Last updated:** 02/26/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | CH9053 | RAILROAD MEDICARE | GA |
| 01 | — | GRP4065 | MEDICARE | GA |