# ADVANCED SLEEP LABORATORY-DUNWOODY

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

## Provider details

- **NPI number:** 1477625051
- **Authorized official:** DR. SAMUEL A MICKELSON MD (PHYSICIAN)
- **Authorized official phone:** (404) 705-0855

## Contact information

- **Practice address:** 960 JOHNSON FERRY RD NE, SUITE 200, ATLANTA, GA 30342-1631
- **Practice address phone:** (404) 705-0855
- **Mailing address:** 750 HAMMOND DR NE BLDG 19, SUITE 100, ATLANTA, GA 30328-6151
- **Mailing address phone:** (404) 705-0855

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QS1200X | Sleep Disorder Diagnostic Clinic/Center | 159916 | GA | Yes |

## Other

- **Enumeration date:** 11/15/2006
- **Last updated:** 01/09/2012