NPI age
18 years
Enumerated 2008-03-03
Across 5448 active family medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 060022 | LICENSE |
| 05 (GA) | 120103132A |
Part of a multi-provider practice. 7 other active providers share this practice address in NPPES.
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