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Contact Information

NICHOLAS J BEAULIEU, MD
920 PONCE DE LEON AVE NE
920 PONCE DE LEON AVE
ATLANTA, GA30306-4212
 Phone: 404-815-1957
 Fax: 404-815-1954
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Preferred Provider Organization

305R00000X
Indicates primary specialty

NPI Profile & details for

NPI # 1679680557
Entity Organization
Organization subpart 1 Not specified
Enumeration date 08/24/2006
Last updated 09/29/2022 - About 4 years ago
Identifiers
GA License # 42176
GA Medicaid 00717076E
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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