The Breast Health Clinic, PC.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

020653 Issued in GA

Legal business name

THE BREAST HEALTH CLINIC, PC.

Practice address

325 North Jeff Davis Drive
Fayetteville, GA 30214

Phone

(770) 461-1337

Fax

(770) 461-0922

NPI assigned

Apr 6, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Stephen Peter Auda, M.D.

Title

President

Phone

(770) 461-1337

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• FKA Stephen P. Auda, M.D., P.C. Former legal business name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319500800000",
    "number": "1417079682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 NORTH JEFF DAVIS DRIVE",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "30214",
            "telephone_number": "770-461-1337",
            "fax_number": "770-461-0922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 NORTH JEFF DAVIS DRIVE",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "30214",
            "telephone_number": "770-461-1337",
            "fax_number": "770-461-0922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BREAST HEALTH CLINIC, PC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2011-10-25",
        "status": "A",
        "authorized_official_last_name": "AUDA",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "PETER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-461-1337",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "GA",
            "license": "020653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00186392A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FKA Stephen P. Auda, M.D., P.C.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Surgery Physician in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.