Organization
SOUTH ATLANTA EAR NOSE & THROAT, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINA JACKSON (BUSINESS MANAGER)
(678) 534-5992
Entity
Organization
Contact information
Practice address
1240 HIGHWAY 54 W STE 710, FAYETTEVILLE, GA 30214-4565
(770) 991-2800
(770) 997-3827
Mailing address
1240 HIGHWAY 54 W STE 710, FAYETTEVILLE, GA 30214-4565
(770) 991-2800
(770) 997-3827
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
09/27/2013
Last updated
04/16/2026
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