NPI age
11 years
Enumerated 2014-07-11
Across 108 active family medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 003148501A | |
| 01 (GA) | 072428 | GEORGIA MEDICAL LICENSE |
Part of a multi-provider practice. 19 other active providers share this practice address in NPPES.
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