Organization
ATLANTA HYPERBARIC & WOUND CARE CLINIC, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLENN L GOODHART M.D. (PHYSICIAN/ OWNER)
(404) 501-7316
Entity
Organization
Contact information
Practice address
2675 N DECATUR RD, SUITE 312, DECATUR, GA 30033-6131
(404) 501-7316
(404) 501-7319
Mailing address
2675 N DECATUR RD, SUITE 312, DECATUR, GA 30033-6131
(404) 501-7316
(404) 501-7319
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
044154
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00861682A
—
GA
01
—
49-05588
UNITED FACILITY ID
GA
01
—
51004393
STATE HEALTH BENEFIT ID
GA
Enumeration date
07/14/2006
Last updated
08/22/2020
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