Basic Information
| Provider Information | |||||||||
| NPI: | 1699977751 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GAGLIOTI | ||||||||
| FirstName: | ANNE | ||||||||
| MiddleName: | HAZEN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 720 WESTVIEW DRIVE SW | ||||||||
| Address2: | HARRIS BLDG., 100-A | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 30310 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4047561400 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1513 CLEVELAND AVE BLDG 500 | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303446949 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4047521000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2007 | ||||||||
| LastUpdateDate: | 10/11/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD036690 | DC | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 38695 | IA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 074224 | GA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.