NPI age
18 years
Enumerated 2008-02-22
Across 58 active clinic/center providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 25BDBQJ | MEDICARE PROVIDER NUMBER |
| 01 (GA) | P00063679 | MEDICARE RAILROAD |
| 01 (GA) | 52598825 | BCBS PROVIDER NUMBER |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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