NPI age
18 years
Enumerated 2008-01-09
Across 2449 active community/behavioral health providers in Georgia.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 00604469D | |
| 01 (GA) | 55002141A | MEDICARE CROSS OVER |
| 01 (GA) | GRP1997 | MEDICARE PROVIDER NUMBER |
Multi-site organization. 1 additional practice location on file.
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