NPI age
18 years
Enumerated 2007-11-29
Across 661 active general practice providers in Georgia.
2 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 1700938123 | INDIVIDUAL NPI |
| 05 (GA) | 00457168C | |
| 01 (GA) | GRP4668 | GROUP PIN |
| 01 (GA) | 1801078001 | GROUP NPI |
Doing-business-as, former, and alternate names recorded by NPPES.
Multi-provider organization. 2 individual providers on file at this primary address.
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