NPI 1275988891

Passport Health Holdings LLC

Organisation Public Health & General Preventive Medicine Physician Decatur, GA

Practice location

Address: 315 W. Ponce de Leon Avenue Suite 585, Decatur, GA 30030-2400
Phone: (877) 358-8648
Fax: (877) 877-6875
Mailing address: 668 N 44th St Suite 100w, Phoenix, AZ 85008-6507

Authorised official

Name: Paul Fishburn
Title: Chief Operating Officer
Phone: (480) 646-9020

Registered specialties

Public Health & General Preventive Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2083P0901X

Other Preventive Medicine providers in Georgia →

Registry record

NPI: 1275988891
Entity type: Organization
NPI issued: 2 May 2016
Record last updated: 1 Apr 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.