| The Concussion Center | |
|
2200 Century Pkwy Ne Ste 260 Atlanta GA 30345-3103 | |
| (404) 946-9327 | |
| Not Available |
| Full Name | The Concussion Center |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2200 Century Pkwy Ne Ste 260, Atlanta, Georgia |
| Authorized Official Name and Position | Brent Jones (CEO) |
| Authorized Official Contact | 4043164136 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Concussion Center 2200 Century Pkwy Ne Ste 260 Atlanta GA 30345-3103 Ph: (404) 946-9327 | The Concussion Center 2200 Century Pkwy Ne Ste 260 Atlanta GA 30345-3103 Ph: (404) 946-9327 |
| NPI Number | 1194309732 |
|---|---|
| Provider Enumeration Date | 05/10/2021 |
| Last Update Date | 12/17/2021 |
| Certification Date | 12/17/2021 |
| Medicare PECOS PAC ID | 5890188494 |
|---|---|
| Medicare Enrollment ID | O20220203000068 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194309732 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0301X | Psychiatry & Neurology - Brain Injury Medicine | (* (Not Available)) | Primary |
| Provider Name | Robert G Bashuk |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1316940547 PECOS PAC ID: 3779534748 Enrollment ID: I20050208000022 |
| Provider Name | Jiovanne N Hughart |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1205837705 PECOS PAC ID: 5991799462 Enrollment ID: I20050520000586 |
| Provider Name | Robert S Allen |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1528448933 PECOS PAC ID: 6709191885 Enrollment ID: I20150819006400 |
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