NPI age
16 years
Enumerated 2009-07-05
Across 247 active clinic/center providers in Georgia.
18 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 1932215845 | CLINICIAN NPI |
| 01 (GA) | 68BBGLB | MEDICARE B |
| 05 (GA) | 750409758A | |
| 01 (GA) | 1162893 | CAQH |
Multi-provider organization. 18 individual providers on file at this primary address.
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