Individual
DR. VIDYA PRADHAN PHOENIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2700 HIGHWAY 34 EAST, BLDG 300, NEWNAN, GA 30265-2315
(678) 423-7700
(678) 423-7710
Mailing address
5901A PEACHTREE DUNWOODY RD, STE 500, ATLANTA, GA 30328-7162
(678) 781-7373
(678) 538-1972
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
059853
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
590932462I
—
GA
Enumeration date
04/24/2007
Last updated
09/03/2020
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