Ear, Nose, Throat, And Allergy Specialists
Otolaryngology in Jasper, GA. Organization (NPI-2).
NPI number1265865232
StatusActive
Last updated in NPPESAug 14, 2013
Details
- NPI
- 1265865232
- Entity type
- Organization (NPI-2)
- Legal business name
- Ear, Nose, Throat, And Allergy Specialists
- Organization subpart
- Yes
- Enumeration date
- Aug 14, 2013
- Last updated
- Aug 14, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Y00000X | Otolaryngology | 30684 | GA | Yes |
Practice location
80a Interstate South DrJasper, GA 30143-6226
Phone 770-345-6600 · Fax 770-345-6611
Mailing address
80a Interstate South DrJasper, GA 30143-6226
Phone 770-345-6600 · Fax 770-345-6611
Authorized official
Ronald Van Tuyl
President
7703456600
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