Eamon Dutta, MD PC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

046593 Issued in GA

Legal business name

EAMON DUTTA, MD PC

Practice address

2150 Peachford Rd
Suite a
Atlanta, GA 30338-6520

Phone

(770) 344-9818

Fax

(770) 458-1596

NPI assigned

Feb 19, 2008

Organization subpart

No

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

Authorized official

Name

Kenneth R Warner

Title

Billing

Phone

(770) 458-1594

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Practitioners 1

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

• Eamon K Dutta, M.D.

  • Psychiatry Physician
  • Atlanta, GA
  • NPI 1396822979
  Medicare reassignment NPD

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

{
    "created_epoch": "1203379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203379200000",
    "number": "1629246137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 PEACHFORD RD",
            "address_2": "SUITE A",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303386520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 PEACHFORD RD",
            "address_2": "SUITE A",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303386520",
            "telephone_number": "770-344-9818",
            "fax_number": "770-458-1596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAMON DUTTA, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-19",
        "last_updated": "2008-02-19",
        "status": "A",
        "authorized_official_last_name": "WARNER",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "770-458-1594"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "046593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Psychiatry Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.