NPI age
19 years
Enumerated 2007-01-09
Across 5448 active family medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (MS) | 02021591 | |
| 01 (GA) | 82134 | GA MD LICENSE |
| 05 (LA) | 2307053 | |
| 01 (GA) | 82134 | MD LICENSE |
| 05 (TX) | 175931802 |
Part of a multi-provider practice. 10 other active providers share this practice address in NPPES.
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