NPI age
19 years
Enumerated 2006-09-05
Across 450 active otolaryngology providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 00705911J | |
| 01 (GA) | 041762 | STATE LICENSE |
| 01 (GA) | 1427151687 | NPI GROUP |
Part of a multi-provider practice. 10 other active providers share this practice address in NPPES.
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