Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Omega Physician Practice LLC

Organization Anesthesiology Physician · NPI 1013658467

Omega Physician Practice LLC is an Anesthesiology Physician in Kennesaw, Georgia. Registered with an NPI since 2022.

In the registry since
2022
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1300 Ridenour Blvd NW
Kennesaw, GA 30152-4501
Phone: (770) 702-1806
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X

Record details

NPI number1013658467
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Rudolph Davis — Anesthesiologist · (205) 317-8437
NPI enumeratedApril 7, 2022
Last updated in NPPESApril 7, 2022
Certification dateApril 7, 2022
Mailing address3927 Concord Walk Dr Se, Smyrna, GA 30082-3659

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