Allergy and ENT of Ga

Organization Active NPI Family Medicine Physician · Dahlonega, GA

NPI 1205919404 · NPPES record last updated Jun 30, 2011

Key facts

NPI
1205919404
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
ALLERGY AND ENT OF GA
Practice address
227 Mountain Dr
Dahlonega, GA 30533-1606
Phone
(706) 867-4306
Fax
(706) 864-1356
NPI assigned
Oct 23, 2006
Organization subpart
Yes
Parent organization (as reported)
SOUTHERN HEALTH CORPORATION OF DAHLONEGA

Authorized official

Name
Mr. Larry R Jeter
Title
Ceo
Phone
(706) 867-4311

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Part of
Southern Health Corporation

Locations

70 Mountain Dr
Ste C
Dahlonega, GA 30533
Phone (706) 867-0145

278 Highway 400 N
Ste 1160
Dawsonville, GA 30534
Phone (706) 265-8439

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X Yes
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207R00000X
Pediatrics Physician
Group: 193200000X MULTI-SPECIALTY GROUP
208000000X

Addresses

Primary practice location

227 Mountain Dr
Dahlonega, GA 30533-1606

Mailing address

PO Box 1449
Dahlonega, GA 30533-0025
Phone (706) 864-1356

Other identifiers

IdentifierTypeStateIssuer
DC7827OtherGARAILROAD MEDICARE GROUP #

Other names

  • Allergy and ENT of GA Doing business as

Other providers in Dahlonega, GA

All providers in Dahlonega, GA · Family Medicine Physician in Georgia

Sources for this page

Verify at the official NPI Registry.