| Organization Name: | PRESTIGE HEALTHCARE ATLANTA, LLC |
| NPI Number: | 1316210156 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHARIS J TRENCH-SIMMONS (OWNER) |
| Mailing Address: | 3886 Princeton Lakes Way Sw Suite 280 Atlanta |
| State: | GA US |
| Postal Code: | 303315511 |
| Phone Number: | 4043467100 |
| Fax Number: | 4043461122 |
| NPI Enumeration Date: | 02/09/2012 |
| NPI Last Update Date: | 02/09/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207V00000X |
| License Number: | 058337 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |