Organization
EAR, NOSE AND THROAT SPECIALISTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNELLE HUFFMAN (PRACTICE MANAGER)
(770) 712-2297
Entity
Organization
Contact information
Practice address
1370 WELLBROOK CIR NE, CONYERS, GA 30012-3872
(770) 922-5458
(678) 750-0988
Mailing address
1370 WELLBROOK CIR NE, CONYERS, GA 30012-3872
(770) 922-5458
(770) 922-0435
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CH9053
RAILROAD MEDICARE
GA
01
—
GRP4065
MEDICARE
GA
Enumeration date
09/06/2006
Last updated
02/26/2025
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