Otis Prestige

LBN: Otis Prestige
Otis Prestige is an health care organization with primary practice located at 109 Anderson St Se Ste 200A , Marietta GA 30060-8610. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Infectious Disease. Allopathic & Osteopathic Physicians / Infectious Disease is the primary health care specialty. Otis Prestige can be contacted via phone (470) 301-8528, or through Drago, Damian via phone (470) 301-8528.

Contact Information

Primary practice address
109 Anderson St Se Ste 200A Marietta GA 30060-8610
Phone: (470) 301-8528
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Drago, Damian ARNP
Phone: (470) 301-8528

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X
Allopathic & Osteopathic Physicians / Infectious Disease 207RI0200X

Profile Details

NPI number 1992431753
LBN Legal business name Otis Prestige
DBA Doing business as
Authorized official Drago, Damian ARNP
Entity Organization
Organization subpart 1 No
Enumeration date Jul 25th, 2022
Last updated Jul 25th, 2022 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992431753 NPPES
Georgia Other 4703018528 4703018528

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