Organization
BAPTIST GROUP OF BUCKHEAD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAVIER A LOPEZ CISNEROS (ADMINISTRATOR)
(404) 735-8641
Entity
Organization
Contact information
Practice address
5456 PEACHTREE INDUSTRIAL BLVD, SUITE 305, ATLANTA, GA 30341-2235
(404) 735-8641
(404) 898-1809
Mailing address
5456 PEACHTREE INDUSTRIAL BLVD, SUITE 305, ATLANTA, GA 30341-2235
(404) 735-8641
(404) 898-1809
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
150425LGB
GA
Other
Enumeration date
03/31/2007
Last updated
08/22/2020
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