Basic Information
Provider Information
NPI: 1992085468
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCKAY
FirstName: RACHEL
MiddleName: AYERS
NamePrefix:  
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Mailing Information
Address1: 2835 BRANDYWINE RD STE 300
Address2:  
City: ATLANTA
State: GA
PostalCode: 303415540
CountryCode: US
TelephoneNumber: 4046941700
FaxNumber:  
Practice Location
Address1: 202 VILLAGE CENTER PKWY BLDG 200-240
Address2:  
City: STOCKBRIDGE
State: GA
PostalCode: 302819044
CountryCode: US
TelephoneNumber: 4042562593
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/27/2011
LastUpdateDate: 09/07/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate: 09/07/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2080P0202X80357GAY Allopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology

No ID Information.


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