Organization
NORTHERN CRESCENT ENDOSCOPY SUITE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANA BAKER (ADMINISTRATOR)
(404) 888-7575
Entity
Organization
Contact information
Practice address
5671 PEACHTREE DUNWOODY RD NE, SUITE 680, ATLANTA, GA 30342-5000
(404) 705-6985
(404) 851-9950
Mailing address
550 PEACHTREE ST NE, SUITE 1600, ATLANTA, GA 30308-2208
(404) 888-7575
(404) 885-7777
Taxonomy
Speciality
Code
Description
License number
State
261QE0800X
Endoscopy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
543655296A
—
GA
Enumeration date
06/21/2006
Last updated
08/24/2011
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