NPI | 1053810622 |
---|---|
Entity Type | Organization |
Authorized Contact | KRISTI I LEE Senior Director 706-513-4897 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine |
207R00000X Internal Medicine | |
208000000X Pediatrics | |
213E00000X Podiatrist | |
2084N0400X Psychiatry & Neurology, Neurology | |
Enumeration Date | 2018-02-08 |
Last Update Date | 2023-12-11 |