# BAPTIST GROUP OF BUCKHEAD

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

## Provider details

- **NPI number:** 1922128875
- **Authorized official:** MR. JAVIER A LOPEZ CISNEROS (ADMINISTRATOR)
- **Authorized official phone:** (404) 735-8641

## Contact information

- **Practice address:** 5456 PEACHTREE INDUSTRIAL BLVD, SUITE 305, ATLANTA, GA 30341-2235
- **Practice address phone:** (404) 735-8641
- **Practice address fax:** (404) 898-1809
- **Mailing address:** 5456 PEACHTREE INDUSTRIAL BLVD, SUITE 305, ATLANTA, GA 30341-2235
- **Mailing address phone:** (404) 735-8641
- **Mailing address fax:** (404) 898-1809

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 150425LGB | GA | Yes |

## Other

- **Enumeration date:** 03/31/2007
- **Last updated:** 08/22/2020