NPI age
19 years
Enumerated 2006-08-07
Across 5448 active family medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | P00322240 | RAILROAD MEDICARE |
| 01 (GA) | 051711 | LICENSE NUMBER |
| 05 (GA) | 000954786C | |
| 01 (GA) | 20-2256065 | FEDERAL TAX ID |
| 01 (GA) | DE8801 | RAILROAD MEDICARE |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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