NPI age
20 years
Enumerated 2005-12-05
Across 5448 active family medicine providers in Georgia.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 | P00040221 | RR MEDICARE |
| 05 (GA) | 767068677A | |
| 05 (NC) | 89066VE | |
| 05 (TN) | 3307782 |
Solo or small practice. No other active providers share this practice address in NPPES.
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