Arun K Kantamneni MD, Inc.
Organization Active NPI Psychiatry Physician · Villa Rica, GA
NPI 1922491695 · NPPES record last updated Mar 5, 2015
Key facts
- NPI
- 1922491695
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 70171 (GA)
- Legal business name
- ARUN K KANTAMNENI MD, INC.
- Practice address
- 20 Herrell Rd
Villa Rica, GA 30180-5527 - Phone
- (770) 881-8495
- NPI assigned
- Mar 5, 2015
- Organization subpart
- No
Authorized official
- Name
- Dr. Arun Kumar Kantamneni, M.D
- Title
- Psychiatrist
- Phone
- (770) 881-8495
Practitioners 5
-
Jessica Perez, LCSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150530000122 | GA | Part B Supplier - Clinic/Group Practice | 7315268539 |
Receives reassigned benefits from 3 practitioners Practice locations: Villa Rica, GA; Smyrna, GA; Cartersville, GA; Carrollton, GA |
National Provider Directory
Locations
958 Joe Frank Harris Pkwy SE
Ste 103
Cartersville, GA 30120
Phone (770) 387-8188
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician |
2084P0800X | 70171 | GA | Yes |
Addresses
Primary practice location
20 Herrell Rd
Villa Rica, GA 30180-5527
Mailing address
PO Box 2287
Duluth, GA 30096-0040
Other providers in Villa Rica, GA
- David I Antokal
- Sylvanus K Anuforo
- Apollo Occupational Health LLC
- Kayla Michelle Arnold
- Shelbie Monique Arnold
- Urooj Ather
- Atrianon, LLC
- Edwidge Azor-Antoine
- Elizabeth Grace Babcock
- George W Bailey
All providers in Villa Rica, GA · Psychiatry Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 5, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.